In the British Journal of Urology International a new study was published that addresses older men's fall risk in relation to urinary issues. The histories of 5872 male patients were investigated to determine if having urinary symptoms were independently associated with a risk for fall within the following 12 months.
The men who reported moderate (39% of men at baseline) or severe (7%) urinary symptoms had a significantly higher incidence of falls over a period of one year than those men who reported mild symptoms. Symptoms that were most associated with falls were urinary urgency, difficulty initiating urine, and nocturia (getting up at least 4x/night to urinate.) The authors reference other studies that reported urinary incontinence as a risk factor for increased fall risk in men as well.
Since benign prostatic hypertrophy (BPH), which causes difficulty initiating the urine stream, and overactive bladder both increase with age, the above urinary issues are understandably of concern when assessing fall risk.
It is also well-known in the orthopedic literature that falls in the elderly increase risk for hip fracture, and 1 year mortality rates are known to be significantly higher for those who have had a hip fracture. Many rehab providers have assisted these patients in their fall recovery, and many factors are at play in making such a recovery challenging. Oftentimes a patient who has suffered a fall and a significant injury have to spend time away from their home, enter environments in which iatrogenic illnesses can occur, and experience the effects of being bed-bound or of having reduced physical activity.
It is valuable to keep such research information in mind when we are educating our colleagues, patients, providers, and community members about the risks of urinary dysfunction. Helping a person maintain healthy bladder function may not only be helping to maximize a person's dignity, but also his level of independence, health, and longevity.