Evidence mapPaperPMID 42435056Full record

ArticleWorld journal of urology2026

Frailty burden and symptomatic BPH/LUTS in aging men: evidence from two nationally representative population-based studies.

Guanwei Wu, Jianghua Wang, Jiewu Shi, Yingqing Liu, Jie Zheng, Xuefeng Jiang, Jiawei Wang, Lijun Pan, Lingsong Tao

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Guanwei Wu *Department of Urology, Affiliated Wuhu Hospital of East China Normal University, Wuhu, 241000, Anhui, China.
Jianghua Wang *Department of Hepatobiliary Pancreatic and Gastrointestinal Surgery, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, 430063, China.
Jiewu Shi *Department of Urology, Affiliated Wuhu Hospital of East China Normal University, Wuhu, 241000, Anhui, China.
Yingqing LiuDepartment of Urology, Affiliated Wuhu Hospital of East China Normal University, Wuhu, 241000, Anhui, China.
Jie ZhengDepartment of Urology, Affiliated Wuhu Hospital of East China Normal University, Wuhu, 241000, Anhui, China.
Xuefeng JiangDepartment of Urology, Affiliated Wuhu Hospital of East China Normal University, Wuhu, 241000, Anhui, China.
Jiawei WangDepartment of Urology, Affiliated Wuhu Hospital of East China Normal University, Wuhu, 241000, Anhui, China.
Lijun PanDepartment of Neurosurgery, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China. panlijun123@163.com.
Lingsong TaoDepartment of Urology, Affiliated Wuhu Hospital of East China Normal University, Wuhu, 241000, Anhui, China. 271292371@qq.com.

Funding

the Research Project of the Affiliated Wuhu Hospital of East China Normal 2024A04the Wuhu Municipal Health Commission Research Project LC2023D03
6 · The paper itself

Abstract

backgroundThe frailty index (FI) is a well-established marker of biological aging and a widely validated predictor of adverse health outcomes in older adults. However, its association with symptomatic benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) has not been well defined in nationally representative populations. This study aimed to evaluate the association between FI levels and symptomatic BPH/LUTS in men using two large population-based studies.

methodsWe analyzed men from the China Health and Retirement Longitudinal Study (CHARLS) and the US National Health and Nutrition Examination Survey (NHANES). Cohort-specific FIs were constructed following the Rockwood-Mitnitski deficit-accumulation approach. Symptomatic BPH/LUTS was operationalized using cohort-specific questionnaire and medication data and included bothersome LUTS with or without physician-diagnosed BPH, depending on data availability in each cohort. Multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations of log-transformed FI (continuous) and FI tertiles with BPH/LUTS. Restricted cubic splines (RCS) were used to assess graded associations and potential nonlinearity, and prespecified subgroup analyses with interaction tests evaluated effect modification. As a supplementary analysis, cohort-specific machine-learning models were internally validated for risk stratification, with SHAP used for model interpretation.

resultsThe analysis included 8,781 men in CHARLS, of whom 1,043 met criteria for BPH/LUTS (11.9%), and 2,539 men in NHANES, with 559 classified as BPH/LUTS (22.0%). Higher log(FI) was associated with higher odds of BPH/LUTS after full adjustment (CHARLS: OR 1.91, 95% CI 1.71-2.13; NHANES: OR 1.47, 95% CI 1.25-1.73). FI tertiles showed graded associations (Model 3; Q3 vs Q1: CHARLS OR 2.91, 95% CI 2.39-3.56; NHANES OR 1.77, 95% CI 1.32-2.37; both P for trend < 0.001). RCS models indicated significant overall associations without evidence of nonlinearity (CHARLS P for nonlinearity = 0.171; NHANES P for nonlinearity = 0.791). Effect modification was observed for drinking status in CHARLS and for age and smoking status in NHANES (all P for interaction ≤ 0.005). Exploratory machine-learning models showed good internal discrimination (CHARLS CatBoost AUC 0.947; NHANES XGBoost AUC 0.925), but these findings require cautious interpretation because external validation was not performed.

conclusionHigher FI levels were associated with a higher prevalence of broadly defined symptomatic BPH/LUTS in two nationally representative populations. Given the cross-sectional design, these findings should be interpreted as associations only, and longitudinal studies are needed to clarify the temporal and causal relationships between frailty burden and BPH/LUTS.

Indexed as

FrailtyLower Urinary Tract SymptomsProstatic HyperplasiaAgedAgingChinaHumansLongitudinal StudiesMaleMiddle AgedUnited StatesAgingBenign prostatic hyperplasiaFrailty indexLower urinary tract symptomsMachine learning

Identifiers

PMID42435056

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.