Clinical implications of using questionnaires in elderly men with urinary disorders

Abstract

Introduction. The frequency of lower urinary tract symptoms (LUTS) progression associated with prostatic hyperplasia in elderly men is increasing despite improvements in early diagnosis methods and the emergence of new drugs. Questionnaires are used to assess the patient's condition on primary admission and to monitor the effectiveness of medical procedures to diagnose the severity of LUTS in clinical practice.Purpose of the study. To compare the effectiveness of LUTS diagnosis in elderly men using different scales: the International Prostate Symptom Index (IPSS) and the Visual Prostate Symptom Scale (VPSS) for differential analysis of the cognitive impairment degree.Materials and methods. The study included 56 men, residents of the Trans-Baikal Territory, over the age of 50 with LUTS of varying severity. All patients completed the VPSS and IPSS questionnaires (IPSS1) independently. Subsequently, the IPSS questionnaire (IPSS2) was completed in cooperation with the urologist. Additionally, respondents were questioned using the Montreal Cognitive Assessment Scale (MoCa-test) to determine the degree of dementia and other cognitive impairments.Results. All patients were divided into 3 groups after analyzing the results of the MoCa test: I — patients with signs of dementia, II — with cognitive impairments, III — no cognitive impairments. The predicted differences were obtained when comparing the results of IPSS1 / IPSS2: the greatest differences were in the patients of the first group (76.47%; p < 0.05), the smallest in the third group (12.5%; p > 0.05); there was an increase in the severity of LUTS with self-completion of questionnaires (IPSS1). When evaluating a similar indicator on the VPSS questionnaire, compared with a more objective response with the participation of a physician (IPSS2), statistically significant differences were not obtained in all groups of participants.Conclusion. The dependence of the objectivity of filling out the questionnaires for the diagnosis of LUTS on the severity of cognitive impairments and the age of the respondents was revealed. A reliable correlation of VPSS indicators with the indices of the validated IPSS scale was established. The new questionnaire may be in demand in the clinical practice of a urologist to assess the degree of LUTS in elderly men, as an alternative to the generally accepted IPSS scale, especially in patients with age-related dementia and other cognitive impairments.