title: Lower Urinary Tract Symptoms and Risk of Nonspine Fractures among Older Community Dwelling U.S. Men.
abstract: Among older men, moderate and severe lower urinary tract symptoms are associated with increased fall risk compared to mild lower urinary tract symptoms. Falls are a major risk factor for fractures. Therefore, we assessed associations of lower urinary tract symptoms with fracture risk in community dwelling U.S. men age 65 years or older.
  
  
  
  We conducted a prospective study in the MrOS (Osteoporotic Fractures in Men Study) cohort. Men were enrolled at 6 U.S. sites. The AUA-SI, lower urinary tract symptoms medication use, fracture risk factors and potential confounders were recorded at baseline and every 2 years thereafter for 4 assessments. Lower urinary tract symptom severity was categorized from the AUA-SI as mild (0 to 7 points), moderate (8 to 19 points) or severe (20 or more points). Associations of lower urinary tract symptom severity with fracture rate were estimated with HRs and 95% CIs from extended proportional hazards regression.
  
  
  
  Among 5,989 men with baseline AUA-SI score and hip bone mineral density measures, 745 incident nonspine fractures occurred during 43,807 person-years of followup. In a multivariable model adjusted for age, enrollment site, baseline hip bone mineral density, falls in the last year and prevalent fracture before baseline, there were no significant associations of moderate (HR 0.9, 95% CI 0.8-1.1) or severe (HR 1.0, 95% CI 0.8-1.3) lower urinary tract symptoms with fracture risk. None of the individual lower urinary tract symptoms assessed on the AUA-SI, including nocturia and urgency, was associated with increased fracture risk.
  
  
  
  In this cohort of older U.S. men, lower urinary tract symptoms were not independently associated with fracture risk.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, Oregon. Electronic address: marshaly@ohsu.edu.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Marshall
authors.affiliation: Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health and Science University, Portland, Oregon.
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Lapidus
authors.affiliation: Department of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health and Science University, Portland, Oregon.
authors.forename: Jack
authors.initials: J
authors.lastname: Wiedrick
authors.affiliation: Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Department of Medicine and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.affiliation: Department of Medicine, Bone and Mineral Unit, Oregon Health and Science University, Portland, Oregon.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orwoll
authors.affiliation: Division of Urologic Oncology, Moores Comprehensive Cancer Center, University of California San Diego, La Jolla, California; Division of Urology, San Diego Veterans Affairs Medical Center, La Jolla, California.
authors.forename: J Kellogg
authors.initials: JK
authors.lastname: Parsons
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D057187:Independent Living; D059411:Lower Urinary Tract Symptoms / Q000150:complications*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States
keywords: aged; fractures, bone; lower urinary tract symptoms; male