Evaluating Potentially Modifiable Risk Factors for Prevalent and Incident Nocturia in Older Adults

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Abstract
Objectives: To examine associations between nocturia and potentially modifiable risk factors in older adults. Design: Secondary analysis of cross-sectional and longitudinal data. Setting: Respondents were selected using population-based sampling, drawing from a single Michigan county in 1983. They were followed through 1990. Participants: Community-living adults aged 60 and older. Measurements: Episodes of nocturia, development of nocturia at 2 years after baseline survey, age, sex, hypertension, diabetes mellitus, drinking fluids before bedtime, amount of fluid intake before bedtime, diuretic use, and 24-hour coffee intake. All measures were self-reported. Results: Bivariate cross-sectional analysis revealed significant associations with two or more episodes of nocturia for hypertension (odds ratio (OR)=1.7, 95% confidence interval (CI)=1.37–2.1), diabetes mellitus (OR=1.51, 95% CI=1.1–2.0), diuretic use (OR=1.7, 95% CI=1.3–2.1), age (OR=1.05 per additional year over 60, 95% 1.03–1.06), and number of cups of coffee (OR=0.93 for each cup of coffee, 95% CI=0.89–0.97). In multivariate analysis, hypertension (OR=1.52, 95% CI=1.2–1.9), diuretic use (OR=1.3, 95% 95% CI=1.0–1.7), and age (OR=1.04 per additional year over 60, 95% 1.03–1.06) were independently associated with two or more nocturia episodes per night. No baseline factors predicted future development of nocturia (save for age, in one model). Conclusion: Hypertension, older age, and diuretic use were independently associated with two or more episodes of nocturia in cross-sectional analysis. No baseline factor was related to the development of nocturia over a 2-year interval in this sample. Nighttime fluid intake and coffee intake, practices providers commonly target in patients with nocturia, were not associated with nocturia in this population-based sample of community-living older adults.