J Bone Metab.  2018 Nov;25(4):267-274. 10.11005/jbm.2018.25.4.267.

Urinary Incontinences Are Related with Fall and Fragility Fractures in Elderly Population: Nationwide Cohort Study

Affiliations
  • 1Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.
  • 2Department of Orthopaedic Surgery, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea.
  • 3Departments of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 4Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.
  • 5Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea. hayongch@naver.com

Abstract

BACKGROUND
This prospective cohort study used nationwide claims data to investigate the incidence of fall and fragility fractures in association with urinary incontinence (UI) in the elderly, and to compare mortality after fragility fractures in elderly patients with or without incontinence.
METHODS
A total of 39,854 Korean adults (age, 66-80 years) who participated in health examinations between 2007 and 2012 and were followed up until 2015 were analyzed. Patient and comparison groups were classified according to the presence or absence of UI. The cumulative incidence of osteoporotic fragility fractures and falls in the 2 groups was assessed and compared. Hazard ratios for fragility fractures were calculated for the risk of UI in association with falls using a Cox proportional hazards model.
RESULTS
Of 39,854 elderly participants, 5,703 were classified in the UI group, while 34,151 were placed in the comparison group. Fall rates were significantly higher (20.8%) in the incontinence group than in the comparison group (4.7%) (P < 0.001). Women in the incontinence group (13.9%) showed a significantly higher incidence of all types of fragility fractures than those in the comparison group (11.8%) (P=0.005). After adjustment for confounders, UI was not a significant risk factor for fragility fractures in men (P=0.878) or women (P=0.324).
CONCLUSIONS
This study demonstrated that elderly women with UI have a significantly higher incidence of osteoporotic fragility fractures. In addition, elderly women are at higher risk for falls.

Keyword

Osteoporotic fractures; Risk factors; Urinary incontinence

MeSH Terms

Accidental Falls
Adult
Aged*
Cohort Studies*
Female
Humans
Incidence
Male
Mortality
Osteoporotic Fractures
Proportional Hazards Models
Prospective Studies
Risk Factors
Urinary Incontinence

Figure

  • Fig. 1 Schematic showing subject involvement in the study. UI, urinary incontinence.


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