Lower urinary tract symptoms (LUTS) are highly prevalent in older adults and particularly impactful in frail populations. Despite their significance, research addressing the intersection of LUTS and frailty remains limited. This study aims to evaluate the research landscape of LUTS in older and frail populations using an artificial intelligence (AI)-powered scientometric platform. By applying novel metrics such as "recency", this analysis identifies emerging topics, long-standing themes, and critical gaps in the literature to inform future research directions.

A comprehensive scientometric analysis was conducted using the Mynd discovery platform, an AI-driven tool that extracts, clusters, and ranks key terminology from PubMed-indexed abstracts. A total of 13,737 publications from 1954 to May 2024 were analyzed. Unsupervised topic modeling was employed to generate hierarchical research clusters. The “recency” metric, which quantifies the momentum of a topic relative to average domain growth, categorized research areas as emerging, mainstream, or declining. Visualizations and topic maps were generated to reflect thematic and chronological trends.

Research output on LUTS in older adults has grown steadily since the 1980s, with peaks in 2014 (n=613) and 2017 (n=612), followed by a decline in annual publication numbers post-2020. Geographical trends show an increasing share of contributions from Asia. Urinary incontinence was the most studied diagnosis (n=3,663), while overactive bladder (n=1,198) and detrusor underactivity (n=107) demonstrated high recency scores (+0.80 and +0.61, respectively), signaling renewed interest. In terms of diagnostics, urodynamic studies (n=1,495) and uroflowmetry (n=1,429) had the most publications but showed negative recency scores (-1.12 and -0.63), indicating declining attention. Medical treatment research was led by antimuscarinics (n=854, recency +1.24), while beta-3 agonists, though less studied (n=256), had the highest recency (+2.09). Surgical treatments were led by sling procedures (n=487, recency -1.80), but prostatic artery embolization emerged as a topic of rising interest (n=70, recency +1.99). Frailty remains underrepresented in the literature, comprising only 2.5% of analyzed studies, but its high recency score (+1.57) indicates a growing recognition of its relevance. Figure 1 illustrates the field map.

This analysis illustrates a shift in the research landscape of LUTS in older populations. Traditional diagnostic and therapeutic approaches - such as urodynamic studies and sling procedures - are receiving less attention, while newer and less invasive options, including beta-3 agonists and prostatic artery embolization, are on the rise. Frailty, although historically underexplored and comprising a small proportion of the literature (2.5%), now shows a strong upward trend with a high recency score. This suggests that research attention toward frailty in the context of LUTS is accelerating and likely to increase significantly in the near future. This analysis is limited by the exclusive use of PubMed and English-language articles.

LUTS research in older populations is evolving, with increasing focus on less invasive and more targeted interventions. While frailty has previously been a neglected topic, the current trend indicates growing recognition of its importance. Addressing this gap through dedicated research will be essential to improving outcomes for aging and vulnerable patient groups.