BMJ Open 3:e002413 doi:10.1136/bmjopen-2012-002413
  • Public health
    • Research

Overactive bladder symptom severity is associated with falls in community-dwelling adults: LOHAS study

  1. Shunichi Fukuhara1
  1. 1Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
  2. 2Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
  3. 3Institute for Health Outcomes & Process Evaluation Research (i-Hope international), Kyoto, Japan
  4. 4Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
  5. 5Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
  6. 6Department of Urology, Juntendo University School of Medicine, Tokyo, Japan
  1. Correspondence to Professor Shunichi Fukuhara; fukuhara.shunichi.6m{at}
  • Received 27 November 2012
  • Revised 14 February 2013
  • Accepted 12 March 2013
  • Published 3 May 2013


Objectives To examine the association between overactive bladder (OAB) symptom severity and falls and the contribution of OAB symptoms to falls in a community-dwelling population.

Design Cross-sectional study.

Setting 2 Japanese municipalities.

Participants A total of 2505 residents aged over 40 years, who participated in health check-ups conducted in 2010. OAB symptom assessed via overactive bladder symptom score (OABSS) was divided into six categories based on distribution and Japanese clinical guidelines. Mobility problems and depressive symptoms were assessed via the Timed Up and Go test and the short form of the Center for Epidemiologic Studies Depression Scale, respectively.

Primary outcome measures Self-reported any fall and frequent fall (≥2) over the 1-month period. Independent contributions to any fall and frequent falls were assessed via logistic regression to generate population-attributable fractions (PAFs), assuming separate causal relationships between OAB symptoms, mobility problems and depressive symptoms and any or frequent falls.

Results Among the total 1350 participants (mean age: 68.3 years) analysed, any fall and frequent falls were reported by 12.7% and 4.4%, respectively. Compared with no OABSS score, moderate-to-severe OAB and mild OAB were associated with any fall (adjusted ORs 2.37 (95% CI 1.12 to 4.98) and 2.51 (95% CI 1.14 to 5.52), respectively). Moderate-to-severe OAB was also strongly associated with frequent falls (adjusted OR 6.90 (95% CI 1.50 to 31.6)). Adjusted PAFs of OAB symptoms were 40.7% (95% CI 0.7% to 64.6%) for any fall and 67.7% (95% CI −23.1% to 91.5%) for frequent falls. Further, these point estimates were similar to or larger than those of mobility problems and depressive symptoms.

Conclusions An association does indeed exist between OAB symptom severity and falls, and OAB symptoms might be important contributors to falls among community-dwelling adults. Further longitudinal studies are warranted to examine whether or not OAB symptoms predict risk of future falls and fall-related injuries.

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