QoL questionnaire predicts nocturia, risk for falling

Sep 23 2013

A study of Japanese outpatients highlights the association between nighttime voiding and bone fractures, after showing that the Nocturia Quality-of-Life (N-QoL) questionnaire can identify patients at risk for both.

The research team, led by Tomonori Yamanishi (Dokkyo Medical University, Mibu, Japan), received questionnaire responses, including the N-QoL, overactive bladder symptom score, and information on nighttime symptoms and falling, from 2494 patients with a mean age of 63.2 years.

Overall, 25.1% had symptoms of overactive bladder and 70.4% reported waking during the night to urinate. The mean N-QoL score was 86.8 out of 100 and 63% of patients had a score greater than 90.

The authors found that N-QoL score was significantly lower in patients with comorbid conditions, in men, and in those who complained of awakening from sleep. N-QoL score also inversely correlated with the frequency of nighttime voiding, nighttime incontinence, and nighttime falling as a result of voiding.

The researchers calculated that an N-QoL cutoff value of 90 or less had 63.1% sensitivity and 78.6% specificity for predicting night-time voiding frequency of more than twice per night, while a cutoff of 80 or less had 70.2% sensitivity and 79.5% specificity for at least one fall in a year.

“Thus, a N-QOL score ≤80 could be a criterion for selecting patients who might require additional care to prevent possible bone fracture caused by falling,” comment the authors, adding that a cutoff value of 90 may identify those patients with bothersome symptoms.

Yamanishi and colleagues say that theirs is the first validation of the Japanese N-QoL in a cross-sectional survey of outpatients from various departments. Given that at least 90% of patients were not recruited from the urology department, they say their finding that 70% reported night-time waking to void is noteworthy.

They write in the International Journal of Urology: “We conclude that the N-QOL could be a useful tool for evaluating the influence of nocturia on daily life and for examining therapeutic effects on the risk of bone fracture as a result of nocturia.”

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