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: 10025786
• 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 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10025786
• 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; Sleep disturbances; 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; 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.

项目摘要/摘要 与目前缺乏有关的基本知识差距和潜在的错过机会 了解较低的尿路症状（LUTS）与年龄较大的脆弱关系之间的关系 男人。患有LUTS的老年男性更有可能遭受跌倒，骨折，功能障碍，健康状况不佳 - 相关的生活质量和死亡率，但是我们目前的LUT治疗并不针对这些结果。此外，我们 对衰老的脆弱和其他系统性过程有限，这是密切相关的 由于功能障碍，可能有助于LUTS的发展。 我们的长期目标是改善与健康相关的生活质量和功能成果 通过创建一个新颖的整体框架来理解非动物学和衰老的贡献 LUT的发展以及LUTS对脆弱和功能结果的影响。这 该应用的目的是评估LUTS之间纵向关联的方向和强度 和脆弱，以识别先前的和潜在的可修改风险因素。我们的核心假设是 LUTS与脆弱之间的关系是双向的，因此LUTS与 脆弱的脆弱性和脆弱性与后悔的情感独立相关。 该假设将通过利用男性的前瞻性观察性骨质骨折来检验 （MROS）追求以下特定目的的研究：目标1）确定 脆弱和令人担忧的luts；目标2）确定LUTS严重程度与 恶化的脆弱。该项目具有创新性，因为它结合并利用了两个以前不同的 概念模型 - 它基于我们先前的工作，展示了强大的横断面关联 在LUTS和脆弱的情况下，评估脆弱性作为以前出乎意料的预测指标或LUT的机制， LUTS是一种意外的预测指标或脆弱的机制。 拟议的研究很重要，因为对这些纵向关系的全面评估是 为了确定新颖的脆弱或LUT机制和治疗方法以及早期脆弱指标所需的所需。 例如，与弱相关的男性可能需要不同于前列腺的干预措施 目前推荐的以膀胱为重点的疗法。或者，某些LUTS域的处理 可以防止或逆转脆弱和随后的功能障碍。这项研究将改善 了解这些条件的潜在双向和相互关系，并将确定新颖 为开发新干预措施的机制，以改善或维持与健康相关的生活质量 和患有LUT的老年男性的身体机能。