(Poster 29) Nocturia and Falls Associations Among LURN 2 Cohort

Objectives: This study was to evaluate the association between nocturia and fall outcomes, including injury and severity of injury.

Methods: This was a secondary analysis of care-seeking participants with urinary urgency symptoms with or without nocturia at one institution in the Lower Urinary Tract Dysfunction Network (LURN 2) observational cohort from 2021 - 2024. Baseline characteristics, patient-reported outcomes, and bladder diary data were collected from the institution’s LURN 2 dataset. Updated patient characteristics and fall outcomes were abstracted from the electronic medical record. Participants with a history of falls before enrollment in LURN 2 were excluded. Bayesian logistic and ordinal regression models with skeptical priors were fit to assess the association between nocturia episodes and fall-related outcomes (absence/presence of injury, number of falls, and ranked injury severity). Injury includes reported sequalae such as loss of consciousness, bruising and laceration, in addition to diagnosed injury like fracture and intracranial bleed. Model covariates included nocturia-related variables, age and arthritis. Any association and non-trivial association were defined as adjusted odds ratio (aOR) of >1 and >1.2 respectively.

Results: Among the 121 participants included, 21.5% experienced at least one fall. The mean (+/-SD) follow-up time was 29.7 (+/- 9.8) months. The mean participant age was 62.7 (+/-13.4) years, and the BMI was 30.4 (+/- 8.37) kg/m2. The median (IQR) number of nocturia episodes was 2 (1,3) episodes, and the mean nighttime volume was 720 (+/- 610) mL. Those who fell were generally older (67.6 vs. 62.2 years) and had a higher BMI (33.2 vs. 29.9 kg/m2). The median aOR for the effect between nocturia episodes and falls was 0.99 (95% credible interval (CI), 0.7, 1.6), yielding a posterior probability of 0.50 and 0.19 for any association and a non-trivial association. Diagnoses of arthritis demonstrated a strong non-trivial association with falls with aOR of 3.1 (95% CI 1.2, 8.5), yielding posterior probability of a non-trivial association of 0.98. Similarly, the median adjusted cumulative odds ratio was 0.99 (95% CI 0.6, 1.7) for the association of nocturia episodes and injury, demonstrating posterior probability of a non-trivial association of 0.24. There was a 0.15 posterior probability of a non-trivial association between the number of nocturia episodes and severity of injury (aOR 0.98, 95% CI 0.6, 1.7).

Conclusions: There is a 50% probability of an effect between nocturia episodes and falls, and moreover, approximately 20% probability of a non-trivial association between the number of nocturia episodes and falls. Similarly, there is a roughly 1 in 4 probability of a non-trivial association between nocturia episodes and the presence of injury. These findings emphasize the important association that nocturia has with falls and injury. Further research on screening for nocturia may be a useful fall prevention strategy.