Abstract
A cross-sectional relationship between lower urinary tract symptoms (LUTS) and depressive symptoms was previously reported among Southern Chinese men; however, the temporal relationship was unclear. Our objective is to evaluate the temporal relationship between moderate to severe lower urinary tract symptoms and clinically significant depressive symptoms in elderly Chinese men aged 65 in a prospective manner. In a prospective cohort of 2,000 Chinese men aged 65 to 92 years in Hong Kong, we studied the association of having moderate to severe LUTS at baseline and having clinically relevant depressive symptoms at year 2 follow-up. After excluding men with prostate or bladder cancer or surgery (n = 20) and lost to follow-up (n = 254), data on 1,726 subjects were analyzed. LUTS were measured by the International Prostate Symptom score; and clinically relevant depressive symptoms were measured by the Geriatric Depression Scale. The multiple logistic regressions showed that the presence of moderate-to-severe LUTS at baseline were significantly associated with increased risk for being depressed at two-year follow-up, with adjustments for demographic, lifestyle, medical factors, weight status and stressful life events (OR = 2.97; CI: 1.70–5.20). Association remained significant with additional adjustments for baseline GDS score (OR = 1.88; CI: 1.03–3.41). LUTS are important risk factors in predicting the presence of clinically relevant depressive symptoms. In elderly men, increased awareness and possible screening are needed to detect the increased risk of clinically relevant depressive symptoms.
Highlights
It has been established that depressive symptoms or depression are related to a number of chronic medical conditions including cardiovascular diseases [1], chronic obstructive pulmonary diseases (COPD) [2], congestive heart diseases [3] and other debilitating conditions
The prevalence of Lower urinary tract symptoms (LUTS) is high and the impact is significant, few prospective studies have been carried out to evaluate the association between LUTS and depressive symptoms which are important to delineate the temporal and causal relationships between LUTS and clinically relevant depressive symptoms
We previously reported the relationship between LUTS and clinically relevant depressive symptoms using data from a crosssectional study [15]
Summary
It has been established that depressive symptoms or depression are related to a number of chronic medical conditions including cardiovascular diseases [1], chronic obstructive pulmonary diseases (COPD) [2], congestive heart diseases [3] and other debilitating conditions. Results from these previous studies showed that the presence of chronic medical conditions was associated with increased risk of having clinically relevant depressive symptoms or depression. The prevalence of LUTS is high and the impact is significant, few prospective studies have been carried out to evaluate the association between LUTS and depressive symptoms which are important to delineate the temporal and causal relationships between LUTS and clinically relevant depressive symptoms
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