Lower urinary tract symptoms and functional ability in older adults: a community-based cross-sectional study

Abstract

Objectives: Functional ability, or the ability to live actively in older age, is essential for healthy ageing. This study assessed the association between the five types of lower urinary tract symptoms (LUTS) and functional ability among community-dwelling older adults (≥65 years old).

Design: A cross-sectional study.

Setting: Community-dwelling older adults (≥65 years old) randomly selected from the basic resident register of Kashiwa city as part of the Kashiwa study.

Participants: The study included 916 community-dwelling older adults (481 male participants) in Japan.

Outcome measures: A self-administered questionnaire was used to collect data regarding LUTS, which included frequency, nocturia, urgency, urinary incontinence and overactive bladder (OAB). Functional ability was measured using the Japan Science and Technology Agency Index of Competence. Sex-stratified logistic regression analyses were conducted, adjusting age, obesity, alcohol consumption, polypharmacy and comorbidities.

Results: Male participants experienced symptoms of frequency, nocturia, urgency, urinary incontinence and OAB at rates of 68.0%, 89.0%, 16.0%, 3.7% and 4.3%, respectively. Female participants experienced these symptoms at rates of 68.3%, 80.0%, 11.0%, 7.4% and 8.5%, respectively. Among male participants, lower functional ability was only associated with nocturia (≥3 times/night) (adjusted OR (AOR): 1.71, 95% CI 1.05 to 2.79). Contrarily, lower functional ability among female participants was significantly associated with frequency (AOR: 1.61, 95% CI 1.04 to 2.49), urgency (AOR: 2.06, 95% CI 1.08 to 3.95) and OAB (AOR: 2.43, 95% CI 1.15 to 5.11).

Conclusion: The different associations between LUTS and functional ability by sex might be related to differences in the effect of comorbidities and physical fatigue. Our results help clarify the multifaceted effects of LUTS in old age, the need for early detection and treatment of LUTS, and the importance of maintaining functional ability.

Keywords: adult urology; geriatric medicine; preventive medicine; social medicine.

Figure 1

The English version of the JST-IC. Scale developers translated the items from Japanese to English. The English version has not been validated. JST-IC, Japan Science and Technology Agency Index of Competence.

Figure 2

Results of the logistic regression analyses predicted lower functional ability with various types of LUTS in older male participants (n=468). The JST-IC was used as a binary dependent variable in which the high and low scores were reversed. In each analysis, age, obesity, alcohol consumption, polypharmacy and comorbidities were adjusted. AOR, adjusted OR; JST-IC, Japan Science and Technology Agency Index of Competence; LUTS, lower urinary tract symptoms; OAB, overactive bladder.

Figure 3

Results of the logistic regression analyses predicted lower functional ability with various types of LUTS in older female participants (n=424). The JST-IC was used as a binary dependent variable in which the high and low scores were reversed. In each analysis, age, obesity, alcohol consumption, polypharmacy and comorbidities were adjusted. AOR, adjusted OR; JST-IC, Japan Science and Technology Agency Index of Competence; LUTS, lower urinary tract symptoms; OAB, overactive bladder.