An Economic Model Evaluating the Cost of Nocturia-Related Falls in Older Women in the Community

OBJECTIVES: Nocturia – the condition of waking at least once per night to void – is common in older adults. The prevalence of significant nocturia (≥2 episodes per night) in US women ranges from 33.1% (60-69 years) to 46.6% (≥80 years). Nocturia decreases quality of life and it has also been associated with an increased risk of falls in elderly community-dwelling adults. Women, who experience two-times the number of medically-treated falls as men, sustained $22.2 billion in non-fatal falls in the US in 2015. The objective of this analysis is to model the incremental annual cost of falls, attributable to nocturia, in older women in the community.

METHODS: A model was constructed evaluating the incidence of falls per year in community-dwelling females (≥ 65 years), the increased risk of falling attributable to nocturia, the percentage of medically-treated falls, and the cost of falls in older females.

RESULTS: 28.9% of females (≥65 years) experience a fall each year in the US. Nocturia (≥3 episodes per night) was associated with an increased risk of falling (RR=1.28). 53.2% of older adults (≥60 years) experiencing a fall required either an emergency department visit or hospitalization with a slightly higher risk (RR=1.01) ascribed to females. The median total Medicare expenditures to one year, for a fall in older adults requiring emergency services, was found to be $26,143. The model determined that $1,255 in additional Medicare expenses will accrue annually in older women in the community who present with nocturia.

CONCLUSIONS: Falls occur frequently in older, community-dwelling females. Nocturia increases the risk of these accidents – events that result in substantial healthcare burden. The incremental annual cost of nocturia-related falls in older females in the community may be a useful component in the analysis of fall-prevention strategies.