A Positive Association Between Frailty and Overactive Bladder in United States Adults

urologyxy
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ABSTRACT

Background

Frailty has been associated with numerous chronic diseases. However, the relationship between frailty and overactive bladder (OAB) has not been thoroughly examined. This study aims to explore the association between frailty and OAB in a large-scale population.

Methods

Data from 11 888 participants aged 20 years or older, who were part of the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, were analyzed. The frailty index was calculated using a validated 49-item deficit accumulation model, with a cutoff value of 0.21 or higher indicating frailty. OAB was diagnosed based on self-reported urgency incontinence, nocturia, and an OAB Symptom Score of 3 or higher. Multivariable logistic regression models were employed, adjusting for demographic factors, lifestyle characteristics, comorbidities, and biochemical markers. Subgroup analyses and restricted cubic splines (RCS) were utilized to evaluate effect modification and potential nonlinear relationships.

Results

A significant positive association was found between frailty and OAB. In the multivariable-adjusted model, the odds ratio (OR) was 2.74 (95% confidence interval [CI]: 2.39−3.13, p < 0.001). The RCS analysis confirmed a nonlinear dose-response relationship (overall p < 0.001). Subgroup analyses demonstrated the consistency of this association across different populations. The association was stronger in non-diabetic individuals (OR = 2.961) and those who engaged in vigorous physical activity (OR = 3.442).

Conclusions

In this study, a robust association between frailty and OAB has been identified. Nevertheless, additional research is necessary to confirm this correlation and to investigate the underlying mechanisms.

Yu, G., Lu, W., Wang, Q., Yin, H., & Li, Y. (2026). A positive association between frailty and overactive bladder in United States adults. Neurourology and Urodynamics. Advance online publication. https://doi.org/10.1002/nau.70222