Impact of Lower Urinary Tract Symptoms and Depression on Health-Related Quality of Life in Older Adults

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Abstract

Purpose

We aimed primarily to investigate the level of health-related quality of life (HRQoL), lower urinary tract symptoms (LUTS), and depression in older adults and secondly to identify the impact of LUTS and depression on HRQoL.

Methods

A community-based cross-sectional study was conducted from April to November 2010. Participants were recruited from five community senior centers serving community dwelling older adults in Jeju city. Data analysis was based on 171 respondents. A structured questionnaire was used to guide interviews; the data were collected including demographic characteristics, body mass index, adherence to regular exercise, comorbidities (hypertension, diabetes mellitus, and osteoarthritis), depression, urinary incontinence, LUTS (measured via the International Prostate Symptom Score [IPSS]), and HRQoL as assessed by use of the EQ-5D Index. Stepwise multiple regression analysis was used to test predictors of HRQoL.

Results

Eighteen percent (18.6%) of the respondents reported depressive symptoms. The mean LUTS score was 8.9 (IPSS range, 0 to 35). The severity of LUTS, was reported to be mild (score, 0 to 7) by 53% of the respondents, moderate (score, 8 to 19) by 34.5%, and severe (score, 20 to 35) by 12.5%. HRQoL was significantly predicted by depression (Partial R ²=0.193, P<0.01) and LUTS (Partial R ²=0.048, P=0.0047), and 24% of the variance in HRQoL was explained.

Conclusions

LUTS and depression were the principal predictors of HRQoL in older adults.

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Most cited references 33

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The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.

Paul Abrams, Linda Cardozo, Magnus Fall … (2002)

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The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study.

Karin Coyne, Chris C Sexton, Debra Irwin … (2008)

To examine the effect overactive bladder (OAB) and other lower urinary tract symptoms (LUTS) on health-related quality of life (HRQoL) in a population sample, as OAB often occurs in conjunction with many other LUTS. A nested case-control analysis was performed on men and women with (cases) and without (controls) OAB, from the EPIC study. OAB was assessed using 2002 International Continence Society definitions. Based on their responses to questions about LUTS, cases were classified into five groups; continent OAB, OAB with incontinence, OAB + postmicturition, OAB + voiding, and OAB + postmicturition + voiding. Both cases and controls were asked questions about symptom bother (OAB-q), generic QoL (EQ-5D), work productivity (Work Productivity and Activity Impairment, WPAI), depressive symptoms (Center for Epidemiologic Studies Depression Scale), sexual satisfaction, and erectile dysfunction (men only) using the Massachusetts Male Aging Study. Cases answered additional condition-specific questions HRQoL (OAB-q short form), Patient Perception of Bladder Condition and work productivity related to a specific health problem (WPAI-SHP). General linear models were used to evaluate group differences. Of the EPIC participants, 1434 identified OAB cases were matched by age, gender and country, with 1434 participants designated as controls. Cases and controls were primarily Caucasian (96.2% and 96.7%, respectively), and most (65%) were female; the mean age was 53.8 and 53.7 years, respectively. Comorbid conditions differed significantly by case/control status, with cases reporting significantly greater rates of chronic constipation, asthma, diabetes, high blood pressure, bladder or prostate cancer, neurological conditions and depression. There were significant differences between the cases and controls in all reported LUTS. The OAB + postmicturition + voiding group reported significantly greater symptom bother, worse HRQoL, higher rates of depression and decreased enjoyment of sexual activity, than the other subgroups. OAB has a substantial, multidimensional impact on patients; OAB with additional LUTS has a greater impact. The diagnosis and treatment of OAB should be considered in conjunction with other LUTS, to maximize treatment options and optimize patient outcomes.

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Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases.

Ji Cheol Bae, Sehyun Kim, Shin-Hyeong Cho … (2005)

This study aimed to determine the cross-cultural adaptation and validation of the Korean version of the EQ-5D in rheumatic conditions. Translation, back-translation and cognitive debriefing were performed according to the EuroQol group's guidelines. For validity, 508 patients were recruited and administered the EQ-5D, Short-Form 36 and condition-specific measures. Construct validity and sensitivity were evaluated by testing a-priori hypotheses. For reliability, another 57 patients repeated the EQ-5D at 1-week interval, and intra-class correlations (ICC) and kappa statistics were estimated. For responsiveness, another 60 patients repeated it at 12-week interval within the context of clinical trial, and standardized response mean(SRM) were calculated. The cross-cultural adaptation produced no major modifications in the scale. The associations of the EQ-5D with the generic- and condition-specific measures were observed as expected in hypotheses: the higher EQ-5Dindex and EQ-5D(VAS) scores, the better health status by generic- or condition-specific measures, and the better functional class. The ICCs were 0.751 and 0.767, respectively, and kappa ranged from 0.455 to 0.772. The SRM were 0.649 and 0.410, respectively. The Korean EQ-5D exhibits good validity and sensitivity in various rheumatic conditions. Although its reliability and responsiveness were not excellent, it seems acceptable if condition-specific measures are applied together.

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Author and article information

Journal

Journal ID (nlm-ta): Int Neurourol J

Journal ID (iso-abbrev): Int Neurourol J

Journal ID (publisher-id): INJ

Title: International Neurourology Journal

Publisher: Korean Continence Society

ISSN (Print): 2093-4777

ISSN (Electronic): 2093-6931

Publication date (Print): September 2012

Publication date (Electronic): 30 September 2012

Volume: 16

Issue: 3

Pages: 132-138

Affiliations

Department of Nursing, Jeju National University College of Nursing, Jeju, Korea.

[1 ]Department of Preventive Medicine, Chosun University School of Medicine, Gwangju, Korea.

[2 ]Department of Computer Science and Statistics, Jeju National University College of Natural Sciences, Jeju, Korea.

[3 ]Department of Journalism and Public Relations, Jeju National University College of Social Science, Jeju, Korea.

[4 ]Department of Nursing, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea.

[5 ]Department of Nursing, Jeju National University Hospital, Jeju, Korea.

Author notes

Corresponding author: Hyo Jeong Song. Department of Nursing, Jeju National University College of Nursing, 102 Jejudaehang-ro, Jeju 690-756, Korea. Tel: +82-64-754-3885 / Fax: +82-64-702-2686 / hjsong@ 123456jejunu.ac.kr

Article

DOI: 10.5213/inj.2012.16.3.132

PMC ID: 3469832

PubMed ID: 23094219

SO-VID: a0e64102-19b5-4268-8f16-a8cd243612b3

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Impact of Lower Urinary Tract Symptoms and Depression on Health-Related Quality of Life in Older Adults

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Abstract

Purpose

Methods

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Conclusions

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Neuronal Signaling

Most cited references 33

The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.

The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study.

Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases.

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