The Association Between Overactive Bladder and Falls and Fractures: A Systematic Review.
INTRODUCTION
Urinary symptoms are associated with an increased risk of falls, but few studies have focused on patients with overactive bladder (OAB). This study aimed to synthesize estimates of the risk of falls and fractures in patients with OAB.


METHODS
Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were systematically searched for observational studies that focused on patients with OAB. When available, data from a non-OAB comparison sample were included. Double independent review and data extraction were performed. Falls and fractures data were summarized by unadjusted and adjusted risks, and percent attributable risk (PAR) of falls and fractures associated with OAB.


RESULTS
Fifteen studies were included in the analyses. The proportion of patients with OAB experiencing at least one fall over a year ranged from 18.9% to 50.0%, and the proportion of patients with OAB experiencing recurrent or serious falls ranged from 10.2% to 56.0%. In studies that included a non-OAB comparison sample, a higher risk of falls was observed in patients with OAB compared to those without. A significantly increased (1.3- to 2.3-fold) adjusted OAB-associated risk of falls was reported, while unadjusted PARs for OAB associated falls ranged from 3.7% to 15.5%. Risk was higher among women and those 65 years of age or older. While analysis of fractures showed elevated point estimates, most studies were underpowered to detect a statistically significant difference between groups.


CONCLUSIONS
Evidence from the published literature clearly demonstrates the importance of OAB and its symptoms as risk factors for falls and fractures.


FUNDING
Astellas.
['Szabo|Shelagh M|SM|0000-0002-9044-3192', 'Gooch|Katherine L|KL|', 'Walker|David R|DR|', 'Johnston|Karissa M|KM|', 'Wagg|Adrian S|AS|']
D000058:Accidental Falls D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D050723:Fractures, Bone D006801:Humans D008297:Male D008875:Middle Aged D012307:Risk Factors D053201:Urinary Bladder, Overactive
Overactive Review Accidental falls Fractures, bone Urinary bladder Urology