Are Nocturia and Falls Associated? A Secondary Analysis

Importance Nocturia is believed to increase falls in older patients, a leading cause of injury-related death; however, the impact of other risk factors in patients with nocturia is limited. Objectives To evaluate the association between nocturia and falls and injury. Study Design This was a secondary analysis of male and female participants from one site of the Lower Urinary Tract Dysfunction Network study. Participants with prior falls were excluded. Bayesian logistic and ordinal regression models were used to estimate associations between nocturia episodes and fall outcomes, adjusting for arthritis, gait instability, and obstructive sleep apnea (OSA). Probability of an association was obtained from the posterior distribution of each model, and any association was defined as the median adjusted odds ratios (aOR) >1. Results Among 121 participants, 21.5% experienced at least one fall. The probability of any association between nocturia episodes and the presence of falls was 0.16 (aOR: 0.9, 95% credible interval (CI), 0.8, 1.1). Arthritis (aOR: 2.0, 95% CI: 1.3, 3.0), gait instability (aOR: 5.5, 95% CI: 3.3, 9.2), and OSA (aOR: 2.4, 95% CI: 1.4, 3.9) demonstrated a high probability of association with falls, with probabilities of 0.99 and 1.0, respectively. The probability of any association between nocturia episodes and injury (aOR: 0.8, 95% CI: 0.7, 1.0) and injury severity (aOR: 0.9, 95% CI: 0.7, 1.1) was 0.05 and 0.10, respectively. Conclusions Nocturia episodes have low probabilities of association with falls, injury, and injury severity after controlling for additional covariates. Fall reduction efforts should focus on additional risk factors in patients with nocturia.