This work was supported by the National Center for Complementary and Integrative Health (grant number K23AT008211 to A.S.) and the National Center for Advancing Translational Sciences (grant number UL1TR002369) at the National Institutes of Health (NIH). This work was also supported by grants and awards to SRB from the National Institute of Diabetes, Digestive, and Kidney Disorders at NIH (grant number 1K12DK111028), the National Institute on Aging at NIH (grant number 1R03AG067937), and the UCSF Claude D. Pepper Older Americans Independence Center funded by National Institute on Aging at NIH (grant number P30 AG044281). MrOS is supported by the NIH, the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center for Advancing Translational Sciences, and the National Institutes of Health Roadmap for Medical Research at the NIH (grant numbers U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01AG042168, U01 AR066160, and UL1 TR000128).
The Journals of Gerontology: Series A
Aging -- Research, Central Nervous System Sensitization, Epidemiology
Musculoskeletal pain, a possible marker of central sensitization, is associated with higher prevalence of lower urinary tract symptoms (LUTS) among older men. We investigated whether musculoskeletal pain is associated with LUTS progression.
Participants were 5 569 men age ≥65 years enrolled in the prospective, multicenter Osteoporotic Fractures in Men (MrOS) Study. Self-reported musculoskeletal pain within 12 months before baseline was categorized as any pain and multilocation pain. Pain interference within 4 weeks of baseline was assessed with the SF-12 questionnaire. LUTS were assessed repeatedly with the American Urological Association Symptom Index (AUA-SI). Men with severe LUTS at baseline were excluded. LUTS progression was defined as the first occurrence of a ≥4-point AUA-SI increase during a 2-year follow-up interval. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated using multivariable pooled logistic regression.
LUTS progression was 37% higher among men with any musculoskeletal pain compared with men without pain (IRR 1.37, 95% CI: 1.21, 1.54). Positive associations were also observed between LUTS progression and pain at 1 (IRR 1.31, 95% CI: 1.13, 1.48) and ≥2 locations (IRR 1.42, 95% CI: 1.24, 1.60). Compared with men without pain interference, men with quite a bit/extreme pain interference were most likely to experience LUTS progression (minimal interference IRR 1.15, 95% CI: 1.03, 1.26; moderate interference IRR 1.28, 95% CI: 1.11, 1.45; quite a bit/extreme interference IRR 1.47, 95% CI: 1.22, 1.71).
Among men initially without severe LUTS, musculoskeletal pain is associated with an increased risk of LUTS progression. Studies using validated measures of central sensitization and LUTS progression among men are warranted.
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Senders, Angela; Bauer, Scott; Chen, Yiyi; Oken, Barry; Fink, Howard A.; Lane, Nancy E.; Sajadi, Kamran P.; and Marshall, Lynn M., "Musculoskeletal Pain, a Possible Indicator of Central Sensitization, Is Positively Associated With Lower Urinary Tract Symptom Progression in Community-Dwelling Older Men" (2023). OHSU-PSU School of Public Health Faculty Publications and Presentations. 542.