Relationship of Lifestyle and Clinical Factors with Lower Urinary Tract Symptoms (LUTS): Results from the Boston Area Community Health (BACH) Survey

Objectives— Since lifestyle factors and comorbidities may influence lower urinary tract symptoms (LUTS) by gender and race/ethnicity differently, we investigated these associations in the Boston Area Community Health (BACH) Survey. Methods— Using a multi-stage stratified cluster random sample, 5506 adults aged 30–79 were enrolled; 2301 men, 3205 women, 1770 Black, 1877 Hispanic, 1859 White. Adiposity, lifestyle factors, comorbidities (cardiovascular diseases, diabetes, high blood pressure, high cholesterol, depressive symptoms, prior urinary tract infections) were considered in predicting the odds of LUTS (American Urological Association Symptom Index 8+) by gender and race/ethnicity. Results— The prevalence of LUTS was 18.7% with similar rates by gender (men 18.7%, women 18.6%) and race/ethnicity (Black 19.3%, Hispanic 16.2%, White 18.9%); however, prevalence did increase substantially with age. Depressive symptoms were associated with increased odds of LUTS across all gender and racial/ethnic groups; overall odds ratio (95% confidence interval): 2.4 (1.9, 3.2), p < 0.001. Age increased the odds of LUTS among all groups. Physical activity decreased the odds of LUTS, particularly among women: 0.4 (0.2, 0.7), p = 0.003 comparing high to low activity. Cardiovascular diseases and prior urinary tract infections increased the odds of LUTS overall: 1.6 (1.2, 2.1), p = 0.004; 1.9 (1.4, 2.4), p < 0.001, respectively, and for most groups. Conclusions— Lifestyle and clinical factors associated with LUTS are similar by gender and race/ ethnicity. population-based, random sample epidemiologic survey of a range of The a with 24 cells (30–39, race/ethnicity (Black,

[1]  J. Mckinlay,et al.  Measuring the urologic iceberg: design and implementation of the Boston Area Community Health (BACH) Survey. , 2007, European urology.

[2]  John T. Wei,et al.  Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. , 2006, Archives of internal medicine.

[3]  Arnold Johnson,et al.  L-NAME, a nitric oxide synthase inhibitor, diminishes oxidative damage in urinary bladder partial outlet obstruction. , 2006, American journal of physiology. Renal physiology.

[4]  D. Brooks,et al.  Female, but not male, serotonin reuptake transporter (5-HTT) knockout mice exhibit bladder instability , 2005, Autonomic Neuroscience.

[5]  A. Serretti,et al.  The influence of Serotonin Transporter Promoter Polymorphism (SERTPR) and other polymorphisms of the serotonin pathway on the efficacy of antidepressant treatments , 2005, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[6]  L. Vatten,et al.  The prevalence and correlates of urinary tract symptoms in Norwegian men: The HUNT Study , 2005, BJU international.

[7]  E. Giovannucci,et al.  Association of cigarette smoking, alcohol consumption and physical activity with lower urinary tract symptoms in older American men: findings from the third National Health And Nutrition Examination Survey , 2005, BJU International.

[8]  J. Lidfeldt,et al.  Prevalence of urinary incontinence in relation to self-reported depression, intake of serotonergic antidepressants, and hormone therapy in middle-aged women: a report from the Women's Health in the Lund Area study , 2005, Menopause.

[9]  R. Roberts,et al.  Prevalence of conditions potentially associated with lower urinary tract symptoms in men , 2005, BJU international.

[10]  E. Giovannucci,et al.  Association between markers of the metabolic syndrome and lower urinary tract symptoms in the Third National Health and Nutrition Examination Survey (NHANES III) , 2005, International Journal of Obesity.

[11]  K. Andersson.  New pharmacologic targets for the treatment of the overactive bladder: an update. , 2004, Urology.

[12]  L. Kiemeney,et al.  The prevalence of lower urinary tract symptoms in men and women in four centres. The UrEpik study , 2003, BJU international.

[13]  V. Nitti,et al.  American Urological Association Symptom Index for lower urinary tract symptoms in women: correlation with degree of bother and impact on quality of life. , 2003, Urology.

[14]  Michael A. Joseph,et al.  Risk factors for lower urinary tract symptoms in a population-based sample of African-American men. , 2003, American journal of epidemiology.

[15]  W. Steers,et al.  Alterations in voiding frequency and cystometry in the clomipramine induced model of endogenous depression and reversal with fluoxetine. , 2003, The Journal of urology.

[16]  M. Barry,et al.  Quality-of-life impact of lower urinary tract symptom severity: results from the Health Professionals Follow-up Study. , 2002, Urology.

[17]  S. Madersbacher,et al.  The prevalence of lower urinary tract symptoms in Austrian males andassociations with sociodemographic variables , 1999, European Journal of Epidemiology.

[18]  C. Turvey,et al.  A Revised CES-D Measure of Depressive Symptoms and a DSM-Based Measure of Major Depressive Episodes in the Elderly , 1999, International Psychogeriatrics.

[19]  E. Rimm,et al.  Physical activity and benign prostatic hyperplasia. , 1998, Archives of internal medicine.

[20]  T. Tammela,et al.  Prevalence of lower urinary tract symptoms in Finnish men: a population-based study. , 1998, British journal of urology.

[21]  J. Ware,et al.  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. , 1996, Medical care.

[22]  P. Masand,et al.  Major depression and irritable bowel syndrome: is there a relationship? , 1995, The Journal of clinical psychiatry.

[23]  M. Chancellor,et al.  American Urological Association symptom index for women with voiding symptoms: lack of index specificity for benign prostate hyperplasia. , 1993, The Journal of urology.

[24]  L. Nyquist,et al.  Specificity of the American Urological Association voiding symptom index: comparison of unselected and selected samples of both sexes. , 1993, The Journal of urology.

[25]  H. Lepor,et al.  Comparison of AUA symptom index in unselected males and females between fifty-five and seventy-nine years of age. , 1993, Urology.

[26]  R C Bruskewitz,et al.  Correlation of the American Urological Association symptom index with self-administered versions of the Madsen-Iversen, Boyarsky and Maine Medical Assessment Program symptom indexes. Measurement Committee of the American Urological Association. , 1992, The Journal of urology.

[27]  M. Barry,et al.  The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. , 1992, The Journal of urology.

[28]  O. Gofrit,et al.  Do atherosclerosis and chronic bladder ischemia really play a role in detrusor dysfunction of old age? , 2005, Urology.

[29]  S. Kaplan,et al.  An unexpected association between urinary incontinence, depression and sexual dysfunction. , 2002, Drugs of today.

[30]  J. Blaivas,et al.  The significance of the American Urological Association symptom index score in the evaluation of women with bladder outlet obstruction. , 2000, The Journal of urology.