Elsevier

Urology

Volume 72, Issue 2, August 2008, Pages 318-321
Urology

Prostatic Diseases and Male Voiding Dysfunction
Prevalence and Characteristics of Lower Urinary Tract Symptoms in Men Aged ≥80 Years

https://doi.org/10.1016/j.urology.2008.03.057Get rights and content

Objectives

We analyzed the prevalence and characteristics of lower urinary tract symptoms (LUTS) in community-dwelling men aged 80 years and older.

Methods

We administered the American Urological Association Symptom Index (AUA-SI) by mail to 291 surviving community-dwelling male participants in the Rancho Bernardo Study, a prospective, community-based study of aging. We compared the prevalence, severity, and types of LUTS occuring in men who were ≥ 80 years to those < 80 years.

Results

The mean age was 74.6 years (standard deviation [SD] 8.9, range 48.3-97.1). One third of the respondents were ≥ 80 years. The mean total AUA-SI score increased steadily by decade of life (P-trend = .002). The prevalence of LUTS was 70% in men ≥ 80 years and 56% in men < 80 years (P = .03). Men ≥ 80 years had significantly higher mean total AUA-SI (P = .05) and were more likely to complain of incomplete emptying (odds ratio [OR] 2.12, 95% confidence interval [CI] 1.06-4.18, P = .02), frequency (OR 1.83, 95% CI 1.00-3.31, P = .03), urgency (OR 1.76, 95% CI 0.96-3.20, P = .05), and weak stream (OR 1.78, 95% CI 1.01-3.12, P = .03).

Conclusions

In this cohort of community-dwelling men, prevalence and severity of LUTS increased into the 10th decade of life. Compared to younger men, men ≥ 80 years were more likely to complain of incomplete emptying, frequency, urgency, and weak stream. Further studies of LUTS in older men are needed to better delineate these associations.

Section snippets

Participants

The Rancho Bernardo study, established in 1972, is a cohort of mostly white, middle- to upper middle–class, community-dwelling adults in Southern California. From 1999 to 2002, 1141 surviving participants attended a research clinic in which 463 men completed a male health history questionnaire. In 2006, we administered the American Urological Association Symptom Index (AUA-SI)9 by mail to the 353 surviving male participants who had not reported a previous diagnosis of prostate cancer at the

Demographics

The mean ± standard deviation age of the 291 responding participants (response rate 82%) was 74.6 ± 8.9 years (range 48.3-97.1). Of the 291 participants, 95 (33%) were ≥80 years; of these, 11 (4%) were ≥90 years. The mean age for those ≥80 years was 85.1 ± 3.8 years (range 80.0-97.1) and for those <80 years was 70.4 ± 6.5 years (range 48.3-79.9). Compared with those <80 years, men ≥80 years old were more likely to have a history of BPH (59% vs 36%, P < .001) or prostate surgery (23% vs 7%, P <

Comment

Although previous studies have examined LUTS in older male populations, to our knowledge this is the first community-based study to analyze, in detail, LUTS among community-dwelling men aged ≥80 years and thus provides novel information as to the prevalence and characteristics of LUTS in this rapidly expanding segment of the male population.

The Rancho Bernardo study included, to our knowledge, the oldest mean age (75 years), greatest proportion of men >80 years (1 in 3), and the oldest living

Conclusions

In this cohort, the prevalence and severity of LUTS continued to increase for men into their 90s. Compared with younger men, men >80 years were more likely to have LUTS and more likely to complain of incomplete emptying, frequency, urgency, and a weak stream. These data show that although the prevalence of LUTS in older men is greater, the symptom patterns change with age. Larger studies are needed to better understand these differences.

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This study was supported by research grants from the National Institutes of Health on Aging (AG07181) and the National Institute of Diabetes and Digestive and Kidney Diseases (DK31801). J. K. Parsons was supported in part by University of California, San Diego, Faculty Senate grant RF821H.

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