Longitudinal Associations Between Frailty and Lower Urinary Tract Symptoms in Older Men

老年男性虚弱与下尿路症状之间的纵向关联

• 批准号: 10263308
• 负责人: Scott Ryan Bauer
• 金额: $ 15.33万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263308
• 关键词: Activities of Daily Living; Age; Aging; Award; Benign Prostatic Hypertrophy; Bladder; Chronic; Cohort Analysis; Communities; Cross-Sectional Studies; Data; Development; Diabetes Mellitus; Elderly; Epidemiologist; Etiology; Evaluation; Foundations; Fracture; Frequencies; Future; Geriatric Assessment; Geriatrics; Goals; Health; Incontinence; Individual; International; Internist; Intervention; Knowledge; Lead; Longitudinal Studies; Measurement; Measures; Medical; Mentorship; Modeling; Muscle; Muscular Atrophy; Nocturia; Outcome; Patients; Personal Satisfaction; Pharmaceutical Preparations; Phenotype; Physical Function; Physical activity; Polyuria; Primary Health Care; Process; Prospective cohort study; Prostate; Public Health; Quality of life; Research; Research Design; Research Personnel; Risk Factors; Severities; Stream; Symptoms; Syndrome; Testing; Urologist; Urology; Work; alternative treatment; associated symptom; cardiovascular health; career; cohort; comorbidity; exhaustion; experience; fall risk; falls; follow-up; frailty; functional disability; functional outcomes; health related quality of life; holistic approach; human old age (65+); improved; indexing; individualized medicine; innovation; lower urinary tract symptoms; men; micturition urgency; modifiable risk; mortality; multidisciplinary; novel; older men; osteoporosis with pathological fracture; poor sleep; prevent; prospective; psychologic; routine screening; side effect; sleep quality; symptom treatment; urinary; urologic

PROJECT SUMMARY/ABSTRACT There is a fundamental knowledge gap and potential missed opportunity related to the current lack of understanding about the relationship between lower urinary tract symptoms (LUTS) and frailty among older men. Older men with LUTS are more likely to suffer from falls, fractures, functional impairment, poor health- related quality of life, and mortality, but our current LUTS treatments do not target these outcomes. Further, we have limited understanding of how frailty and other systemic processes of aging, which are strongly associated with functional impairment, may contribute to the development of LUTS. Our long-term goal is to improve health-related quality of life and functional outcomes among older men with LUTS by creating a novel holistic framework for understanding the contribution of non-urologic and aging factors to the development of LUTS as well as the impact of LUTS on frailty and functional outcomes. The objective of this application is to evaluate the direction and strength of longitudinal associations between LUTS and frailty in order to identify preceding and potentially modifiable risk factors. Our central hypothesis is that the relationship between LUTS and frailty is bidirectional, such that LUTS are independently associated with worsening frailty and that frailty is independently associated with worsening LUTS. This hypothesis will be tested by leveraging the prospective, observational Osteoporotic Fractures in Men (MrOS) Study to pursue the following specific aims: Aim 1) To determine the longitudinal association between frailty and worsening LUTS; and Aim 2) To determine the longitudinal association between LUTS severity and worsening frailty. This project is innovative because it combines and leverages two previously distinct conceptual models – it builds upon our prior work demonstrating the strong cross-sectional association between LUTS and frailty to evaluate frailty as a previously unexplored predictor or mechanism of LUTS and LUTS as an unexplored predictor or mechanism of frailty. The proposed research is significant because a comprehensive evaluation of these longitudinal relationships is needed in order to identify novel frailty or LUTS mechanisms and treatments as well as early frailty indicators. For example, men with frailty-associated LUTS may require different interventions than the prostate and bladder-focused therapies that are currently recommended. Alternatively, treatments for certain LUTS domains may prevent or reverse frailty and subsequent functional impairment. This research will result in an improved understanding of the potential bidirectional and reciprocal relationship of these conditions and will identify novel mechanisms to inform the development of new interventions to improve or maintain health-related quality of life and physical function among older men with LUTS.

项目概要/摘要 由于当前缺乏相关知识，存在基本知识差距和潜在的错失机会。 了解老年人下尿路症状 (LUTS) 与虚弱之间的关系 患有 LUTS 的老年男性更容易跌倒、骨折、功能障碍、健康状况不佳。 相关的生活质量和死亡率，但我们目前的 LUTS 治疗并不针对这些结果。 对衰弱和其他系统性衰老过程的了解有限，这些过程与衰老密切相关 功能障碍，可能会导致 LUTS 的发生。 我们的长期目标是改善老年男性的健康相关生活质量和功能结果 LUTS 通过创建一个新颖的整体框架来理解非泌尿系统和衰老的贡献 LUTS 发展的因素以及 LUTS 对虚弱和功能结果的影响。 此应用程序的目的是评估 LUTS 之间纵向关联的方向和强度 和虚弱，以识别先前的和潜在的可改变的风险因素。 LUTS 与虚弱之间的关系是双向的，因此 LUTS 与以下各项独立相关： 虚弱加剧，而虚弱与 LUTS 恶化独立相关。 这一假设将通过利用男性骨质疏松性骨折的前瞻性、观察性研究进行检验 (MrOS) 研究追求以下具体目标： 目标 1) 确定之间的纵向关联 虚弱和恶化的 LUTS；以及 目标 2) 确定 LUTS 严重程度与 该项目具有创新性，因为它结合并利用了两种先前截然不同的疾病。 概念模型——它建立在我们之前的工作基础上，展示了强大的横截面关联 LUTS 和虚弱之间的关系，以评估虚弱作为 LUTS 的先前未探索的预测因子或机制， LUTS 作为一种未经探索的衰弱预测因子或机制。 所提出的研究意义重大，因为对这些纵向关系的综合评估是 需要识别新的衰弱或 LUTS 机制和治疗方法以及早期衰弱指标。 例如，患有与虚弱相关的 LUTS 的男性可能需要与前列腺和其他疾病不同的干预措施。 目前推荐的针对膀胱的治疗，或者针对某些 LUTS 领域的治疗。 可以预防或逆转虚弱和随后的功能障碍。这项研究将导致改善。 了解这些条件的潜在双向和相互关系，并将识别新的 为制定新干预措施以改善或维持与健康相关的生活质量提供信息的机制 患有 LUTS 的老年男性的身体功能。