Relationship of lifestyle and clinical factors to lower urinary tract symptoms: results from Boston Area Community Health survey

Abstract

Objectives: Because lifestyle factors and comorbidities can influence lower urinary tract symptoms (LUTS) by sex and race/ethnicity differently, we investigated these associations in the Boston Area Community Health survey.

Methods: Using a multistage stratified cluster random sample, 5506 adults aged 30 to 79 years were enrolled (2301 men, 3205 women, 1770 blacks, 1877 Hispanics, and 1859 whites). Adiposity, lifestyle factors, comorbidities (cardiovascular diseases, diabetes, high blood pressure, high cholesterol, depressive symptoms, previous urinary tract infections) were considered in predicting the odds of LUTS (American Urological Association Symptom Index of 8 or greater) by sex and race/ethnicity.

Results: The prevalence of LUTS was 18.7%, with similar rates by sex (men 18.7%, women 18.6%) and race/ethnicity (black 19.3%, Hispanic 16.2%, white 18.9%); however, the prevalence did increase substantially with age. Depressive symptoms were associated with increased odds of LUTS across all sex and racial/ethnic groups. The overall odds ratio was 2.4 (95% confidence interval 1.9 to 3.2, P <0.001). Age increased the odds of LUTS among all groups. Physical activity decreased the odds of LUTS, particularly in women (odds ratio 0.4, 95% confidence interval 0.2 to 0.7, P = 0.003, comparing high and low activity). Cardiovascular diseases and previous urinary tract infections increased the odds of LUTS overall (odds ratio 1.6, 95% confidence interval 1.2 to 2.1, P = 0.004; and odds ratio 1.9, 95% confidence interval 1.4 to 2.4, P <0.001, respectively) and for most groups.

Conclusions: The results of this study have shown that the lifestyle and clinical factors associated with LUTS are similar by sex and race/ethnicity.