Journal of Cancer Survivorship

, Volume 8, Issue 3, pp 497–507 | Cite as

Coexistence of urinary incontinence and major depressive disorder with health-related quality of life in older Americans with and without cancer

  • Alexandra J. White
  • Bryce B. Reeve
  • Ronald C. Chen
  • Angela M. Stover
  • Debra E. Irwin
Article

Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

Keywords

Urinary incontinence Major depressive disorder Health-related quality of life Cancer Survivor 

Notes

Acknowledgments

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.

References

  1. 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. 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. 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.
  4. 4.
    Siegel R et al. Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin. 2012;62(4):220–41.CrossRefPubMedGoogle Scholar
  5. 5.
    Bellizzi KM, Rowland J. The role of comorbidity, symptoms and age in the health of older survivors following treatment for cancer. Aging Health. 2007;3:625635.CrossRefGoogle Scholar
  6. 6.
    Rao AV, Demark-Wahnefried W. The older cancer survivor. Crit Rev Oncol Hematol. 2006;60(2):131–43.CrossRefPubMedGoogle Scholar
  7. 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.
  8. 8.
    Kessler RC et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289(23):3095–105.CrossRefPubMedGoogle Scholar
  9. 9.
    Serby M, Yu M. Overview: depression in the elderly. Mt Sinai J Med. 2003;70(1):38–44.PubMedGoogle Scholar
  10. 10.
    Pirl WF. Evidence report on the occurrence, assessment, and treatment of depression in cancer patients. J Natl Cancer Inst Monogr. 2004;32:32–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Gelenberg AJ. The prevalence and impact of depression. J Clin Psychiatry. 2010;71(3):e06.CrossRefPubMedGoogle Scholar
  12. 12.
    Anger JT et al. The prevalence of urinary incontinence among community dwelling men: results from the National Health and Nutrition Examination Survey. J Urol. 2006;176(5):2103–8. Discussion 2108.CrossRefPubMedGoogle Scholar
  13. 13.
    Anger JT et al. The prevalence of urinary incontinence among community dwelling adult women: results from the National Health and Nutrition Examination Survey. J Urol. 2006;175(2):601–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Markland AD et al. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol. 2011;186(2):589–93.PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Coyne KS et al. 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. BJU Int. 2008;101(11):1388–95.CrossRefPubMedGoogle Scholar
  16. 16.
    Girman CJ et al. Health-related quality of life associated with lower urinary tract symptoms in four countries. Urology. 1998;51(3):428–36.CrossRefPubMedGoogle Scholar
  17. 17.
    O’Donnell M et al. Help-seeking behaviour and associated factors among women with urinary incontinence in France, Germany, Spain and the United Kingdom. Eur Urol. 2005;47(3):385–92. Discussion 392.CrossRefPubMedGoogle Scholar
  18. 18.
    Rosen RC, Giuliano F, Carson CC. Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Eur Urol. 2005;47(6):824–37.CrossRefPubMedGoogle Scholar
  19. 19.
    Kwong PW et al. Urinary incontinence and quality of life among older community-dwelling Australian men: the CHAMP study. Age Ageing. 2010;39(3):349–54.CrossRefPubMedGoogle Scholar
  20. 20.
    Manchana T. Long-term lower urinary tract dysfunction in gynecologic cancer survivors. Asian Pac J Cancer Prev APJCP. 2011;12(1):285–8.PubMedGoogle Scholar
  21. 21.
    Parsons BA, Evans S, Wright MP. Prostate cancer and urinary incontinence. Maturitas. 2009;63(4):323–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Porter MP, Penson DF. Health related quality of life after radical cystectomy and urinary diversion for bladder cancer: a systematic review and critical analysis of the literature. J Urol. 2005;173(4):1318–22.CrossRefPubMedGoogle Scholar
  23. 23.
    Reeve BB et al. Impact of diagnosis and treatment of clinically localized prostate cancer on health-related quality of life for older Americans: a population-based study. Cancer. 2012;188(22):5679–87.CrossRefGoogle Scholar
  24. 24.
    White AJ et al. Urinary incontinence and health-related quality of life among older Americans with and without cancer: a cross-sectional study. BMC Cancer. 2013;13:377.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 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
  26. 26.
    Collado Serra A et al. AdVance/AdVance XP transobturator male slings: preoperative degree of incontinence as predictor of surgical outcome. Urology. 2013;81(5):1034–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Plotti F et al. Urinary incontinence after radical vulvectomy treated with Macroplastique implantation. J Minim Invasive Gynecol. 2008;15(1):113–5.CrossRefPubMedGoogle Scholar
  28. 28.
    Plotti F et al. Post radical hysterectomy urinary incontinence: a prospective study of transurethral bulking agents injection. Gynecol Oncol. 2009;112(1):90–4.CrossRefPubMedGoogle Scholar
  29. 29.
    Avery JC et al. Identifying the quality of life effects of urinary incontinence with depression in an Australian population. BMC Urol. 2013;13:11.PubMedCentralCrossRefPubMedGoogle Scholar
  30. 30.
    Ambs A et al. Overview of the SEER–Medicare Health Outcomes Survey linked dataset. Health Care Financ Rev. 2008;29(4):5–21.PubMedCentralPubMedGoogle Scholar
  31. 31.
    National Cancer Institute. Surveillance, epidemiology and end results. [cited 2012 1 December]. Available from: www.seer.cancer.gov.
  32. 32.
    Rost K, Burnam MA, Smith GR. Development of screeners for depressive disorders and substance disorder history. Med Care. 1993;31(3):189–200.CrossRefPubMedGoogle Scholar
  33. 33.
    Whooley MA et al. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 1997;12(7):439–45.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Fleishman JA, Selim AJ, Kazis LE. Deriving SF-12v2 physical and mental health summary scores: a comparison of different scoring algorithms. Qual Life Res. 2010;19(2):231–41.CrossRefPubMedGoogle Scholar
  35. 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.
  36. 36.
    Jones 3rd N, Jones SL, Miller NA. The Medicare Health Outcomes Survey program: overview, context, and near-term prospects. Health Qual Life Outcomes. 2004;2:33.PubMedCentralCrossRefPubMedGoogle Scholar
  37. 37.
    Hays RD, Farivar SS, Liu H. Approaches and recommendations for estimating minimally important differences for health-related quality of life measures. COPD. 2005;2(1):63–7.CrossRefPubMedGoogle Scholar
  38. 38.
    Felde G, Bjelland I, Hunskaar S. Anxiety and depression associated with incontinence in middle-aged women: a large Norwegian cross-sectional study. Int Urogynecol J. 2012;23(3):299–306.CrossRefPubMedGoogle Scholar
  39. 39.
    Sims J et al. Urinary incontinence in a community sample of older adults: prevalence and impact on quality of life. Disabil Rehabil. 2011;33(15–16):1389–98.CrossRefPubMedGoogle Scholar
  40. 40.
    Wyrwich KW et al. A comparison of clinically important differences in health-related quality of life for patients with chronic lung disease, asthma, or heart disease. Health Serv Res. 2005;40(2):577–91.PubMedCentralCrossRefPubMedGoogle Scholar
  41. 41.
    Kosinski M et al. Determining minimally important changes in generic and disease-specific health-related quality of life questionnaires in clinical trials of rheumatoid arthritis. Arthritis Rheum. 2000;43(7):1478–87.CrossRefPubMedGoogle Scholar
  42. 42.
    Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.CrossRefPubMedGoogle Scholar
  43. 43.
    Bell JR. Underdiagnosis of depression in primary care: by accident or design? JAMA. 1997;277(18):1433.CrossRefPubMedGoogle Scholar
  44. 44.
    Hakkinen JT et al. Depressive symptoms increase the incidence of nocturia: Tampere Aging Male Urologic Study (TAMUS). J Urol. 2008;179(5):1897–901.CrossRefPubMedGoogle Scholar
  45. 45.
    Tannenbaum C et al. Comorbidities associated with bladder dysfunction. Int J Clin Pract. 2013;67(2):105–13.CrossRefPubMedGoogle Scholar
  46. 46.
    Avis NE et al. Age-related longitudinal changes in depressive symptoms following breast cancer diagnosis and treatment. Breast Cancer Res Treat. 2013;139(1):199–206.CrossRefPubMedGoogle Scholar
  47. 47.
    Giese-Davis J et al. Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol. 2011;29(4):413–20.PubMedCentralCrossRefPubMedGoogle Scholar
  48. 48.
    Bennett JA et al. Time since diagnosis as a predictor of symptoms, depression, cognition, social concerns, perceived benefits, and overall health in cancer survivors. Oncol Nurs Forum. 2010;37(3):331–8.CrossRefPubMedGoogle Scholar
  49. 49.
    Pirl WF et al. Major depressive disorder in long-term cancer survivors: analysis of the National Comorbidity Survey Replication. J Clin Oncol. 2009;27(25):4130–4.PubMedCentralCrossRefPubMedGoogle Scholar
  50. 50.
    Palsson SP, Ostling S, Skoog I. The incidence of first-onset depression in a population followed from the age of 70 to 85. Psychol Med. 2001;31(7):1159–68.PubMedGoogle Scholar
  51. 51.
    Roberts RE et al. Does growing old increase the risk for depression? Am J Psychiatry. 1997;154(10):1384–90.CrossRefPubMedGoogle Scholar
  52. 52.
    Forsell Y, Winblad B. Incidence of major depression in a very elderly population. Int J Geriatr Psychiatry. 1999;14(5):368–72.CrossRefPubMedGoogle Scholar
  53. 53.
    Djernes JK. Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatr Scand. 2006;113(5):372–87.CrossRefPubMedGoogle Scholar
  54. 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
  55. 55.
    Bodhare TN, Valsangkar S, Bele SD. An epidemiological study of urinary incontinence and its impact on quality of life among women aged 35 years and above in a rural area. Indian J Urol. 2010;26(3):353–8.PubMedCentralCrossRefPubMedGoogle Scholar
  56. 56.
    Delgado-Sanz MC et al. Heath-related quality of life in Spanish breast cancer patients: a systematic review. Health Qual Life Outcomes. 2011;9:3.PubMedCentralCrossRefPubMedGoogle Scholar
  57. 57.
    Johansson M, Ryden A, Finizia C. Mental adjustment to cancer and its relation to anxiety, depression, HRQL and survival in patients with laryngeal cancer—a longitudinal study. BMC Cancer. 2011;11:283.PubMedCentralCrossRefPubMedGoogle Scholar
  58. 58.
    Jorngarden A, Mattsson E, von Essen L. Health-related quality of life, anxiety and depression among adolescents and young adults with cancer: a prospective longitudinal study. Eur J Cancer. 2007;43(13):1952–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Alexandra J. White
    • 1
  • Bryce B. Reeve
    • 2
    • 3
  • Ronald C. Chen
    • 2
    • 4
  • Angela M. Stover
    • 2
    • 5
  • Debra E. Irwin
    • 1
    • 2
  1. 1.Department of EpidemiologyUniversity of North CarolinaChapel HillUSA
  2. 2.Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillUSA
  3. 3.Department of Health Policy and ManagementUniversity of North CarolinaChapel HillUSA
  4. 4.Department of Radiation OncologyUniversity of North CarolinaChapel HillUSA
  5. 5.Department of Health BehaviorUniversity of North CarolinaChapel HillUSA

Personalised recommendations