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Minerals, trace elements, Vit. D and bone health

Vitamin D and incident urinary incontinence in older adults

Subjects

Abstract

Background/Objectives:

The aim of this study is to determine whether vitamin D status is associated with incident urinary incontinence (UI) among community-dwelling older adults.

Subjects/Methods:

The University of Alabama at Birmingham Study of Aging is a prospective cohort study of community-dwelling Medicare enrollees. Standardized assessment of UI was conducted using the validated Incontinence Severity Index. The analysis of 25-hydroxyvitamin D [25(OH)D] levels was performed on stored baseline sera. UI was assessed every 6–12 months for up to 42 months. The analyses included multivariable logistic regression and Cox proportional hazard models.

Results:

Of 350 participants (175 male, 147 black, mean age 73.6±5.8), 54% (189/350) were vitamin D deficient (25(OH)D <20 ng/ml) and 25% (87/350) were vitamin D insufficient (25(OH)D: 20 ng/ml to <30 ng/ml). Among the 187 subjects with no UI at baseline, 57% (107/187) were vitamin D deficient and 24% (45/187) were vitamin D insufficient. A total of 175 of the 187 subjects had follow-up evaluation for incident UI over 42 months, and incident UI occurred in 37% (65/175). After adjustment, cumulative incident UI at 42 months was associated with baseline vitamin D insufficiency (P=0.03) and demonstrated a trend association with deficiency (P=0.07). There was no association between baseline vitamin D status and the time to incident UI.

Conclusions:

These preliminary results support an association between vitamin D and incident UI in community-dwelling older adults. Future studies may target specific at-risk groups, such as men with BPH or women with pelvic floor disorders for evaluation of the impact of vitamin D supplementation on urinary symptoms.

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References

  1. Fultz NH, Herzog AR . Self-reported social and emotional impact of urinary incontinence. J Am Geriatr Soc 2001; 49: 892–899.

    Article  CAS  Google Scholar 

  2. Brown JS, Wittinghoff E, Wyman JF, Stone KL, Nevitt MC, Ensrud KE et al. Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 2000; 48: 721–725.

    Article  CAS  Google Scholar 

  3. Grimby A, Milsom I, Molander U, Wiklund I, Ekelund P . The influence of urinary incontinence on the quality of life of elderly women. Age Ageing 1993; 22: 82–89.

    Article  CAS  Google Scholar 

  4. Chiarelli PE, Mackenzie LA, Osmotherly PG . Urinary incontinence is associated with an increase in falls: a systematic review. Aust J Physiother 2009; 55: 89–95.

    Article  Google Scholar 

  5. Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. J Urol 2012; 188: 2455–2463.

    Article  Google Scholar 

  6. Gopal M, Haynes K, Bellamy SL, Arya LA . Discontinuation rates of anticholinergic medications used for the treatment of lower urinary tract symptoms. Obstetr Gynecol 2008; 112: 1311–1318.

    Article  Google Scholar 

  7. Verhamme KMC, Dieleman JP, Bleumink GS, Bosch JLHR, Stricker BHC, Sturkenboom MCJM . Treatment strategies, patterns of drug use and treatment discontinuation in men with LUTS suggestive of benign prostatic hyperplasia: the Triumph project. Eur Urol 2003; 44: 539–545.

    Article  CAS  Google Scholar 

  8. Crescioli C, Morelli A, Adorini L, Ferruzzi P, Luconi M, Vannelli GB et al. Human bladder as a novel target for vitamin D receptor ligands. J Clin Endocrinol Metab 2005; 90: 962–972.

    Article  CAS  Google Scholar 

  9. Bischoff HA, Borchers M, Gudat F, Duermueller U, Theiler R, Stahelin HB et al. In situ detection of 1,25-dihydroxyvitamin D3 receptor in human skeletal muscle tissue. Histochem J 2001; 33: 19–24.

    Article  CAS  Google Scholar 

  10. Schwartz GG . Vitamin D and the epidemiology of prostate cancer. Semin Dial 2005; 18: 276–289.

    Article  Google Scholar 

  11. Badalian SS, Rosenbaum PF . Vitamin D and pelvic floor disorders in women: results from the National Health and Nutrition Examination Survey. Obstetr Gynecol 2010; 115: 795–803.

    Article  CAS  Google Scholar 

  12. Vaughan CP, Johnson TM II, Goode PS, Redden DT, Burgio KL, Markland AD . Vitamin D and lower urinary tract symptoms among US men: results from the 2005-2006 National Health and Nutrition Examination Survey. Urology 2011; 78: 1292–1297.

    Article  Google Scholar 

  13. Navaneethan PR, Kekre A, Jacob KS, Varghese L . Vitamin D deficiency in postmenopausal women with pelvic floor disorders. J Midlife Health 2015; 6: 66–69.

    PubMed  PubMed Central  Google Scholar 

  14. Colli E, Rigatti P, Montorsi F, Artibani W, Petta S, Mondaini N et al. BXL628, a novel vitamin D3 analog arrests prostate growth in patients with benign prostatic hyperplasia: a randomized clinical trial. Eur Urol 2006; 49: 82–86.

    Article  CAS  Google Scholar 

  15. Allman RM, Sawyer P, Crowther M, Strothers HS, Turner T, Fouad MN . Predictors of 4-year retention among African American and white community-dwelling participants in the UAB study of aging. Gerontologist 2011; 51 (Suppl 1), S46–S58.

    Article  Google Scholar 

  16. Sandvik H, Seim A, Vanvik A, Hunskaar S . A severity index for epidemiological surveys of female urinary incontinence: comparison with 48- hour pad-weighing tests. Neurourol Urodyn 2000; 19: 137–145.

    Article  CAS  Google Scholar 

  17. Goode PS, Burgio KL, Redden DT, Markland A, Richter HE, Sawyer P et al. Population based study of incidence and predictors of urinary incontinence in black and white older adults. J Urol 2008; 179: 1449–1454.

    Article  Google Scholar 

  18. Streng T, Andersson K-E, Hedlund P, Gratzke C, Baroni E, D'Ambrosio D et al. Effects on bladder function of combining elocalcitol and tolterodine in rats with outflow obstruction. BJU Int 2012; 110: E125–E131.

    Article  CAS  Google Scholar 

  19. Cartwright R, Mangera A, Tikkinen KAO, Rajan P, Pesonen J, Kirby AC et al. Systematic review and meta-analysis of candidate gene association studies of lower urinary tract symptoms in men. Eur Urol 2014; 66: 752–768.

    Article  CAS  Google Scholar 

  20. Holick MF . Vitamin D deficiency. N Engl J Med 2007; 357: 266–281.

    Article  CAS  Google Scholar 

  21. Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds). Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press: Washington, DC, USA, 2010.

    Google Scholar 

  22. Hansen KE, Johnson R, Chambers KR, Johnson MG, Lemon CC, Vo TN et al. Treatment of vitamin D insufficiency in postmenopausal women: a randomized clinical trial. JAMA Int Med 2015; 175: 1612–1621.

    Article  Google Scholar 

  23. Avenell A, MacLennan GS, Jenkinson DJ, McPherson GC, McDonald AM, Pant PR et al. Long-term follow-up for mortality and cancer in a randomized placebo-controlled trial of vitamin D3 and/or calcium (RECORD trial). J Clin Endocrinol Metab 2012; 97: 614–622.

    Article  CAS  Google Scholar 

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Acknowledgements

This study was funded by the following: A Consortium Multi-Institutional Collaborative Translational Research Pilot award under grant numbers UL1TR000454 and UL1TR000165 from the National Center for Advancing Translational Sciences of the National Institutes of Health and Veterans Health Administration Career Development Awards (CDA-2) to ADM (B6126W) and CPV (1 IK2 RX000747-01). The University of Alabama at Birmingham Study Of Aging was funded through NIA AG15062. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs.

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Correspondence to C P Vaughan.

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Vaughan, C., Tangpricha, V., Motahar-Ford, N. et al. Vitamin D and incident urinary incontinence in older adults. Eur J Clin Nutr 70, 987–989 (2016). https://doi.org/10.1038/ejcn.2016.20

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  • DOI: https://doi.org/10.1038/ejcn.2016.20

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