Coexistence of urinary incontinence and major depressive disorder with health-related quality of life in older Americans with and without cancer
- 355 Downloads
This study evaluates the prevalence and factors associated with major depressive disorder (MDD) in a population of cancer survivors and the impact of co-occurring MDD and urinary incontinence (UI) on health-related quality of life (HRQOL).
The prevalence of MDD risk among cancer survivors (breast, prostate, bladder, colorectal, lung, and endometrial/uterine cancers) and those without cancer was estimated using the Surveillance, Epidemiology and End Results Program-Medicare Health Outcomes Survey (SEER-MHOS) linked database (n = 9,282 with cancer/n = 289,744 without cancer). Risk for MDD was measured using three items from the Diagnostic Interview Schedule, and HRQOL was measured by the SF-36. UI was defined as self-reported leakage of urine causing a problem in previous 6 months. Factors associated with MDD were investigated using logistic regression, and the impact of co-occurring MDD and UI on HRQOL scores was determined using linear regression.
The prevalence of MDD risk ranged from 19.2 % for prostate to 34.1 % for lung. Lung cancer diagnosis was associated with risk of MDD. Being ≥5 years from diagnosis was associated with decreased risk of MDD (prevalence odds ratio (POR) = 0.82, 95 % confidence interval (95 % CI) 0.71, 0.95). The coexistence of both UI and MDD was associated with a decrease across HRQOL subscales; including 40 points on role-emotional (RE) score.
Cancer survivors reporting co-occurrence of UI and MDD experienced significant decrements in HRQOL.
Implications of Cancer Survivors
Understanding the combined effect of UI and MDD may help clinicians to better recognize and alleviate their effects on cancer survivors’ HRQOL.
KeywordsUrinary incontinence Major depressive disorder Health-related quality of life Cancer Survivor
This study is supported in part by grant ES07018 from the National Institute of Environmental Health Sciences and by the UNC Lineberger Cancer Control Education Program (R25 CA57726).
Conflict of interest
The authors have no conflicts of interest or financial disclosures.
- 1.Centers for Disease Control and Prevention. The state of aging and health in America Center for Disease Control. 2007 [cited 2012 1 December 2012]. Available from: http://apps.nccd.cdc.gov/SAHA/Default/Default.aspx.
- 2.Ries LAG et al. SEER Cancer Statistics Review, 1975-2004. 2007 [cited 2012 1 December 2012]. Available from: http://seer.cancer.gov/csr/1975_2004/.
- 3.Howlander N et al. SEER Cancer Statistics Review, 1975-2009 (Vintage 2009 Populations). 2011. Available from: http://seer.cancer.gov/csr/1975_2009_pops09/ based on November 2011 SEER data submission, posted to the SEER web site, April 2012.
- 7.CDC. Current depression among adults—United States, 2006 and 2008. 2010 [cited 2012]; Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5938a2.htm?s_cid=mm5938a2_e%0d%0a.
- 25.Non-surgical treatments for urinary incontinence in adult women: diagnosis and comparative effectiveness comparative effectiveness review Summary Guides for Clinicians. 2007, Rockville MD.Google Scholar
- 31.National Cancer Institute. Surveillance, epidemiology and end results. [cited 2012 1 December]. Available from: www.seer.cancer.gov.
- 35.Ware JE, Kosinski MA. Interpreting SF-36 summary health measures: a response. [cited 2012 1 December]. Available from: http://www.sf-36.org/news/qolrsupplement.pdf.
- 54.Gyhagen M et al. The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG Int J Obstet Gynaecol. 2012.Google Scholar