PD36-09 PREVENTING FALLS IN OLDER WOMEN WITH OVERACTIVE BLADDER: THE IMPACT OF FESOTERODINE ON FALLS RISK, PHYSICAL FUNCTIONING, AND BALANCE

Abstract

INTRODUCTION AND OBJECTIVES: Anticholinergics are widely used for the treatment of overactive bladder (OAB), but there is ongoing concern that anticholinergics may increase risk of falls and neurocognitive changes in older adults. Our objective was to assess changes in physical and neurocognitive function in older women initiating treatment with fesoterodine for OAB symptoms. METHODS: We conducted a prospective cohort study of women aged 65 and older with OAB undergoing treatment with fesoterodine over 8 weeks. Women were included if they had urinary urgency of quite a bit or more on the OAB Questionnaire-Short Form. Participants were treated with flexible doses of fesoterodine. Outcomes included measurement of physical function using accelerometry and self-reported questionnaires, falls (prior to and during the trial), balance (Short Physical Performance Battery), neurocognitive function (Mini Cog), and urinary symptoms (OABq-SF, Urogenital Distress Inventory-6, Patient Global Impression of Improvement). RESULTS: Seventy-four women participated in the study (mean age 76.5±7.2, 63.5% white, mean Charlson Comorbidity score of 4), with 75% follow-up at 8 weeks. Outcomes are presented in Table 1. There were no significant changes from baseline in selfreported physical activity, though there was a decrease in daily steps and energy expenditure and increased sedentary behavior as measured by accelerometer. There were no differences in falls before and during the study. Balance scores and proportion of participants with abnormal Mini Cog scores were unchanged after treatment. Urinary symptoms significantly improved after treatment (p≤0.01). Change in daily steps and MET (metabolic equivalent to task) were not associated with change in urinary symptoms as measured by the UDI-6 and OABq-SF (p=0.32 to 0.97). CONCLUSIONS: Following 8 weeks of treatment with fesoterodine, older women with OAB experienced significant improvement in urinary symptoms without deleterious effects on physical activity, falls, balance, and neurocognitive function. Improvement in urinary symptoms was not associated with an increase in physical activity. (Table Presented).