Overactive Bladder Symptom Severity Is Associated With Falls in Community-Dwelling Adults: LOHAS Study.

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

BMJ Open. 2013; 3(5):
Kurita N, Yamazaki S, Fukumori N, Otoshi K, Otani K, Sekiguchi M, Onishi Y, Takegami M, Ono R, Horie S, Konno S, Kikuchi S, Fukuhara S

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.Cross-sectional study.2 Japanese municipalities.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.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.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.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. HubMed – depression


Killing the Quality and Outcomes Framework won’t decrease prescribing for depression.

BMJ. 2013; 346: f2742
Kendrick T

HubMed – depression


The relationship between depressive symptoms and erythropoietin resistance in stable hemodialysis patients with adequate iron stores.

Int J Artif Organs. 2013 May 6; 0
Afsar B

Introduction: Resistance to erythropoietin (EPO) treatment has been associated with inflammation and malnutrition in hemodialysis (HD) patients. Depression has also been associated with both inflammation and malnutrition; however, the specific relationship between depressive symptoms and EPO resistance is not known. In the current study, the relationship between depressive symptoms and EPO resistance as evaluated by erythropoiesis stimulating agent (ESA) hyporesponsiveness index (EHRI) was analyzed. ?Methods: Study participants had their medical history taken and underwent physical examination; dialysis adequacy calculation, biochemical analysis and evaluation of depressive symptoms by Beck Depression Inventory (BDI) were performed. EHRI was calculated as the weekly dose of EPO divided by per kilogram of body weight divided by the hemoglobin level.?Results: The mean BDI score of the patients was 10.99 ± 3.94. Pearson correlation analysis revealed that the logarithmically converted EHRI score was correlated with albumin (r = -0.270, p = 0.011), hs-CRP (r = 0.383, P<0.0001), hemoglobin (r = -0.617, p<0.0001), intact PTH (r = 0.215, p = 0.043) and logarithmically converted BDI (r = 0.299, p = 0.004). The stepwise linear regression analysis revealed that being female (p = 0.012), presence of diabetes mellitus (p = 0.119), hs-CRP (p = 0.009) and BDI score (p = 0.037) were independently related with logarithmically converted EHRI (as a dependent variable). ?Conclusion: Depressive symptoms were independently related with EHRI in HD patients. Studies are needed to highlight underlying mechanisms between depression and EHRI. HubMed – depression