Nocturia and Comprehensive Geriatric Assessment Parameters in Older Men

Yıl 2020, Cilt: 3 Sayı: 3, 84 - 91, 31.12.2020

Pinar Soysal Lee Smıth Ekrem Dutoglu Igor Grabovac Nicola Veronese Ahmet Turan Işık

https://doi.org/10.47141/geriatrik.820881

Cited By: 1

Öz

Aim: The aim of this study was to demonstrate the relationship between nocturia and geriatric syndromes, and comprehensive geriatric assessment parameters (CGA) in older men.

Material and Methods: A total of 397 older outpatient men who had undergone CGA were included in this cross-sectional study. For the nocturia variable, the question, ‘Generally, during the past 30 days, how many times did you usually urinate after you have gone to sleep at night until the time you got up in the morning?’’ was used.

Results: The mean age of patients was 75.6 ± 8.1. There was a significant positive correlation between the frequency of nocturia and number of drugs, Timed-up Go, and Insomnia severity score (p<0.05), while there was a significant negative correlation between Mini Nutritional Assessment, Basic activities of daily living (BADL) and Tinetti total score, and hand grip strength (p<0.05). The prevalence of patients with 0, ≥1, ≥2, ≥3, and ≥4 nocturnal episodes was 11.6%, 88.4%, 70.5%, 47.3% and 25.4%, respectively. Patients with nocturia ≥2 had lower MNA scores and had a higher fall risk, depression, and dynapenia compared to patients with nocturia ≤1. There were higher rates of insomnia, depression, frailty, dynapenia, lower BADL and nutritional status with ≥3 nocturia episodes compared to ≤ 2 nocturia episodes (p<0.05).

Conclusions: Nocturia is common and associated with dynapenia, insomnia, frailty, polypharmacy, incontinence, increased fall risk and depression in older men. Therefore, nocturia is important for geriatric practice and ≥3 nocturia episodes may be used as a marker of poor health status in older men.

Anahtar Kelimeler

Nocturia, geriatric assessment, insomnia, men, muscle strength

Geriatrik Erkeklerde Nokturi ve Ayrıntılı Geriatrik Değerlendirme Parametreleri

Öz

Amaç: Bu çalışmanın amacı yaşlı erkeklerde noktüri ile geriatrik sendromlar arasındaki ilişkiyi ve ayrıntılı geriatrik değerlendirme parametreleri (AGD) göstermektir.

Gereç ve Yöntemler: Bu kesitsel çalışmaya AGD uygulanan toplam 397 daha yaşlı ayakta hasta erkek dahil edildi. Noktüri değişkeni için, "Genel olarak, son 30 gün içinde, gece uyuduktan sonra sabah kalkana kadar genellikle kaç kez idrara çıktınız?" sorusu kullanılmıştır.

Bulgular: Hastaların ortalama yaşı 75,6±8,1 idi. Noktüri sıklığı ile ilaç sayısı, Kalk ve Yürü testi, İnsomnia Şiddet Skoru arasında pozitif (p<0,05); Mini Nütrisyon Değerlendirmesi (MNA), Temel Günlük Yaşam Aktiviteleri (TGYA), Tinetti toplam skoru ve el kavrama gücü arasında negatif (p<0,05) korelasyon vardı. 0, ≥1, ≥2, ≥3 ve ≥4 noktürnal epizodlu hastaların prevalansı sırasıyla %11,6, %88,4, %70,5, %47,3 ve %25,4 idi. Noktüri ≥2 olan hastalar, noktürisi 1 olan hastalara kıyasla daha düşük MNA skorlarına ve daha yüksek düşme riski, depresyon ve dinapeni gösterdiler. 2 noktüri epizodlarına göre ≥3 nokturi atakları ile daha yüksek uykusuzluk, depresyon, kırılganlık, dinapeni, daha düşük TGYA ve beslenme durumu oranları vardı (p <0.05).

Sonuç: Nokturi yaygındır ve yaşlı erkeklerde dinapeni, uykusuzluk, kırılganlık, polifarmasi, inkontinans, artmış düşme riski ve depresyon ile ilişkilidir. Bu nedenle noktüri, geriatri pratiği için önemlidir ve ≥3 noktüri atakları, yaşlı erkeklerde kötü sağlık durumunun bir belirteci olarak kullanılabilir.

Anahtar Kelimeler

Noktüri, ayrıntılı geriatrik değerlendirme, kas gücü, uykusuzluk

Kaynakça

• 1. van Doorn B, Bosch JLHR. Nocturia in older men. Maturitas. 2012;71(1):8–12.
• 2. Bosch JLHR, Weiss JP. The prevalence and causes of nocturia. J Urol. 2013;189(1 Suppl):S86-92.
• 3. Cornu J-N, Abrams P, Chapple CR, et al. A contemporary assessment of nocturia: definition, epidemiology, pathophysiology, and management--a systematic review and meta-analysis. Eur Urol. 2012;62(5):877–90.
• 4. Kujubu DA, Aboseif SR. An overview of nocturia and the syndrome of nocturnal polyuria in the elderly. Nat Clin Pract Nephrol. 2008;4(8):426–35.
• 5. Dutoglu E, Soysal P, Smith L, et al. Nocturia and its clinical implications in older women. Arch Gerontol Geriatr. 2019;85:103917.
• 6. Park J, Kim ES, Lee YJ, et al. Sex Differences in Lower Urinary Tract Symptoms in Older Korean Adults Living in Rural Areas: Prevalence, Quality of Life, and Associated Factors. Int Neurourol J. 2018;22(3):212–9.
• 7. Unutmaz GD, Soysal P, Tuven B, et al. Costs of medication in older patients: Before and after comprehensive geriatric assessment. Clin Interv Aging. 2018; 9;13:607-613.
• 8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Diagnostic Stat Man Ment Disord 4th Ed TR. 2013;280.
• 9. Soysal P, Isik AT, Arik F, et al. Validity of the Mini-Nutritional Assessment Scale for Evaluating Frailty Status in Older Adults. J Am Med Dir Assoc. 2019 ;20(2):183–7.
• 10. Dokuzlar O, Koc Okudur S, Smith L, et al. Assessment of factors that increase risk of falling in older women by four different clinical methods. Aging Clin Exp Res. 2020;32(3):483-490.
• 11. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
• 12. Soysal P, Smith L, Dokuzlar O, et al. Relationship Between Nutritional Status and Insomnia Severity in Older Adults. J Am Med Dir Assoc. 2019;20(12):1593–8.
• 13. Ates Bulut E, Soysal P, Isik AT. Frequency and coincidence of geriatric syndromes according to age groups: single-center experience in Turkey between 2013 and 2017. Clin Interv Aging. 2018;13:1899–905. 14. van Kerrebroeck P, Abrams P, Chaikin D, et al. The standardisation of terminology in nocturia: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):179–83.
• 15. Endeshaw YW, Schwartz A V, Stone K, et al. Nocturia, Insomnia Symptoms and Mortality among Older Men: The Health, Aging and Body Composition Study. J Clin sleep Med JCSM Off Publ Am Acad Sleep Med. 2016;12(6):789–96.
• 16. Feldstein CA. Nocturia in arterial hypertension: a prevalent, underreported, and sometimes underestimated association. J Am Soc Hypertens. 2013;7(1):75–84.
• 17. Romero JC, Knox FG. Mechanisms underlying pressure-related natriuresis: the role of the renin-angiotensin and prostaglandin systems. State of the art lecture. Hypertens (Dallas, Tex 1979). 1988;11(6 Pt 2):724–38.
• 18. Asplund R. Nocturia in relation to sleep, somatic diseases and medical treatment in the elderly. BJU Int. 2002 Oct;90(6):533–6.
• 19. Verhamme KMC, Dieleman JP, Van Wijk MAM, et al. Nonsteroidal anti-inflammatory drugs and increased risk of acute urinary retention. Arch Intern Med. 2005;165(13):1547–51.
• 20. Kang D, Andriole GL, Van De Vooren RC, et al. Risk behaviours and benign prostatic hyperplasia. BJU Int. 2004;93(9):1241–5.
• 21. Woodard TJ, Manigault KR, McBurrows NN, et al. Management of Benign Prostatic Hyperplasia in Older Adults. Consult Pharm. 2016;31(8):412–24.
• 22. Lee YJ, Jeong SJ, Byun SS, et al. Prevalence and correlates of nocturia in community-dwelling older men: results from the korean longitudinal study on health and aging. Korean J Urol. 2012;53(4):263–7.
• 23. Lightner DJ, Krambeck AE, Jacobson DJ, et al. Nocturia is associated with an increased risk of coronary heart disease and death. BJU Int. 2012;110(6):848–53.
• 24. van Kerrebroeck P, Rezapour M, Cortesse A, et al. Desmopressin in the treatment of nocturia: a double-blind, placebo-controlled study. Eur Urol. 2007;52(1):221–9.
• 25. Drake M. Nocturia and depressive symptoms in older men. Vol. 120, BJU international. England; 2017. p. 159.
• 26. Obayashi K, Saeki K, Negoro H, et al. Nocturia increases the incidence of depressive symptoms: a longitudinal study of the HEIJO-KYO cohort. BJU Int. 2017;120(2):280–5.
• 27. Iwamura M, Kanauchi M. A cross-sectional study of the association between dynapenia and higher-level functional capacity in daily living in community-dwelling older adults in Japan. BMC Geriatr. 2017;17(1):1.
• 28. Pratt TS, Suskind AM. Management of Overactive Bladder in Older Women. Curr Urol Rep. 2018;19(11):92.
• 29. Jang I-Y, Lee CK, Jung H-W, et al. Urologic symptoms and burden of frailty and geriatric conditions in older men: the Aging Study of PyeongChang Rural Area. Clin Interv Aging. 2018;13:297–304.
• 30. Bliwise DL, Howard LE, Moreira DM, et al. Nocturia and associated mortality: observational data from the REDUCE trial. Prostate Cancer Prostatic Dis. 2019;22(1):77–83.