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

项目总结/摘要 存在着根本性的知识差距，而且由于目前缺乏 了解老年人下尿路症状（LUTS）与虚弱的关系 男人患有LUTS的老年男性更容易发生福尔斯、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。我们还 对虚弱和其他系统性衰老过程的理解有限， 功能障碍，可能有助于发展下尿路症状。 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通过创建一个新的整体框架，以了解非泌尿系统和衰老的贡献 影响LUTS发展的因素以及LUTS对虚弱和功能结局的影响。的 本申请的目的是评估LUTS之间纵向关联的方向和强度 和虚弱，以确定先前的和潜在的可改变的风险因素。我们的中心假设是， LUTS和虚弱之间的关系是双向的，使得LUTS独立地与 虚弱恶化，虚弱与LUTS恶化独立相关。 该假设将通过利用前瞻性、观察性男性骨质疏松性骨折进行检验。 （MrOS）研究旨在实现以下具体目标：目标1）确定 目的2）确定LUTS严重程度与 虚弱恶化这个项目是创新的，因为它结合并利用了两个以前不同的 概念模型-它建立在我们先前的工作，证明了强有力的横截面关联 在LUTS和虚弱之间进行评估，以将虚弱作为先前未探索的LUTS预测因子或机制， LUTS作为一个未探索的预测或脆弱的机制。 建议的研究是有意义的，因为这些纵向关系的综合评价是 为了确定新的虚弱或LUTS机制和治疗以及早期虚弱指标， 例如，患有虚弱相关LUTS的男性可能需要与前列腺不同的干预， 目前推荐的以膀胱为中心的治疗方法。或者，某些LUTS结构域的治疗 可以预防或逆转虚弱和随后的功能损害。这项研究将改善 了解这些条件的潜在双向和相互关系，并将确定新的 为制定新的干预措施提供信息的机制，以改善或维持与健康有关的生活质量 和身体功能的影响。

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.