Aging Clinical and Experimental Research

, Volume 19, Issue 6, pp 465–471 | Cite as

Association of urgency symptoms with self-rated health, mood and functioning in an older population

  • Maria NuotioEmail author
  • Teuvo L. J. Tammela
  • Tiina Luukkaala
  • Marja Jylhä
Original Articles


Background and aims: Lower urinary tract symptoms (LUTS) with comorbidities are common in old age. The aim here was to investigate the associations of urgency symptoms with self-rated health, mood and functioning in a random older population adjusted for comorbid conditions. Methods: A population-based cross-sectional survey was made involving 343 people (159 men and 184 women) aged 70 years and over. LUTS were categorized as symptoms with or without urgency. Perceived inconvenience from LUTS, self-rated health, mood, social activity and activities of daily living (ADL), instrumental activities of daily living (IADL) and mobility disability were the outcome measures. Age-and gender-adjusted and multivariate logistic regression models were constructed in order to examine the associations of urgency and non-urgency symptoms with the outcomes. The covariates were age, gender, and self-reported cardiovascular, musculoskeletal, neurological and other chronic diseases. Results: Perceived inconvenience from urgency symptoms was more frequent than that from non-urgency symptoms (64% vs 20%, p<0.001). In the age- and gender-adjusted logistic regression models, LUTS with urgency were associated with poor self-rated health (OR [odds ratio] 2.35; 95% CI [confidence interval] 1.06–5.20), depressive mood (OR 7.29; 95% CI 2.91–18.30), ADL (OR 2.33; 95% CI 1.10–4.92), IADL (OR 2.16; 95% CI 1.19–3.92) and mobility disability (OR 2.44; 95% CI 1.37–4.36). LUTS without urgency were associated with depressive mood (OR 5.02; 95% CI 1.97–12.82) and mobility disability (OR 1.97; 95% CI 1.10–3.53). In the multivariate analyses in which comorbid conditions were added to the model, the associations of non-urgency and urgency symptoms persisted only with depressive mood (OR 4.00; 95% CI 1.52–10.53 and OR 6.16; 95% CI 2.39–15.84, respectively). Conclusion: Urgency symptoms are associated with poor self-rated health, depressive mood and disability in older people. There is an independent association between both urgency and non-urgency LUTS and depressive mood. A careful assessment of the mental state of older individuals with LUTS is warranted.


Aged depression health quality of life urinary dysfunction 


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  1. 1.
    Naughton MJ, Wyman JF. Quality of life in geriatric patients with lower urinary tract dysfunction. Am J Med Sci 1997; 314: 219–27.PubMedCrossRefGoogle Scholar
  2. 2.
    DuBeau CE, Subbarao VY, Resnick NM. Implications of the most bothersome prostatism symptoms for clinical care and outcomes research. J Am Geriatr Soc 1995; 43: 985–92.PubMedGoogle Scholar
  3. 3.
    Echardt MD, Van Venrooij GEPM, Van Melick HHE, Boon TA. Prevalence and bothersomeness of lower urinary tract symptoms in benign prostatic hyperplasia and their impact on well-being. J Urol 2001; 166: 563–8.CrossRefGoogle Scholar
  4. 4.
    Grimby A, Milsom I, Molander U, Wiklund I, Ekelund P. The influence of urinary incontinence on the quality of life of elderly women. Age Ageing 1993; 22: 82–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Ouslander JG. Geriatric considerations in the diagnosis and management of overactive bladder. Urology 2002; 60 (Suppl 1): 50–5.PubMedCrossRefGoogle Scholar
  6. 6.
    Kawada T. Self-rated health and life prognosis. Arch Med Res 2003; 34: 343–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Blazer DG, Hybels CF. What symptoms of depression predict mortality in community-dwelling elders? J Am Geriatr Soc 2004; 52: 2052–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Scott WK, Macera CA, Cornman CB, Sharpe PA. Functional health status as predictor of mortality in men and women over 65. J Clin Epidemiol 1997; 2993: 343–7.Google Scholar
  9. 9.
    Glass TA, DeLeon CM, Marottoli RA, Berkman LF. Population-based study of social and productive activities as predictors of survival in elderly Americans. BMJ 1999; 319: 478–83.PubMedCrossRefGoogle Scholar
  10. 10.
    Berzon R, Hays RD, Shumaker SA. International use, application and performance of health-related quality of life instruments. Qual Life Res 1992; 2: 367–8.CrossRefGoogle Scholar
  11. 11.
    Maggi S, Minicuci N, Langlois J, Pavan M, Enzi G, Crepaldi G. Prevalence rate of urinary incontinence in community-dwelling elderly individuals. The Veneto Study. J Gerontol A Biol Sci Med 2001; 56: M14–8.CrossRefGoogle Scholar
  12. 12.
    Dugan EM, Cohen SJ, Bland DF, et al. The association of depressive symptoms and urinary incontinence among older adults. J Am Geriatr Soc 2000; 48: 413–6.PubMedGoogle Scholar
  13. 13.
    Fulz NJ, Herzog RH. Self-reported social and emotional impact of urinary incontinence. J Am Geriatr Soc 2001; 49: 892–9.CrossRefGoogle Scholar
  14. 14.
    Johnson TM 2nd, Kincade JE, Bernard SL, Busby-Whitehead J, Herz-Picciotto I, DeFriese GH. The association of urinary incontinence with poor self-rated health. J Am Geriatr Soc 1998; 46: 693–9.PubMedGoogle Scholar
  15. 15.
    Koskimäki J, Hakala M, Huhtala H, Tammela TLJ. Is reduced quality of life in men with lower urinary tract symptoms due to concomitant diseases? Eur Urol 2001; 40: 661–5.PubMedCrossRefGoogle Scholar
  16. 16.
    McGrother CW, Donaldson MK, Hayward T, Matthews R, Dallosso H, Hyde C. The Leicesterhire MRC Incontinence Study Team. Urinary storage symptoms and comorbidities:a prospective population cohort study in middle aged and older women. Age Ageing 2006; 35: 16–24.Google Scholar
  17. 17.
    Jylhä M, Jokela J, Tolvanen E, et al. The Tampere Longitudinal Study on Ageing. Description of the Study. Basic results on health and functional ability. Scand J Soc Med 1992; (Suppl 47): 1–58.Google Scholar
  18. 18.
    Nuotio M, Jylhä M, Luukkaala T, Tammela TLJ. Urgency, urge incontinence and voiding symptoms in men and women aged 70 years and over. BJU Int 2002; 89: 350–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Hoyl MT, Alessi CA, Harker JO, et al. Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc 1999; 47: 873–8.PubMedGoogle Scholar
  20. 20.
    Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: Report from the Standardisation Sub-Committee of the International Continence Society. Neurourol Urodyn 2002; 21: 167–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Ali A, Snape J. Nocturia in older people: a review of causes, consequences, assessment and management. Int J Clin Pract 2004; 58: 366–73.PubMedCrossRefGoogle Scholar
  22. 22.
    van Kerrebroeck P, Abrams P, Chaikin D, et al. Standardisation of terminology in nocturia: report from the Standardisation Sub-Committee of the International Continence Society. Neurourol Urodyn 2002; 21: 179–83.PubMedCrossRefGoogle Scholar
  23. 23.
    Nilsson SE, Johansson B, Karlsson D, Berg S, McClerns GE. A comparison of diagnosis capture from medical records, self-reports, and drug-registrations: study in individuals aged 80 years and older. Aging Clin Exp Res 2002; 14: 178–84.PubMedCrossRefGoogle Scholar
  24. 24.
    Okamura K, Usami T, Nagahama K, Maruyama S, Mizuta E. The relationships among filling, voiding subscores from international prostate symptoms score and quality of life in Japanese elderly men and women. Eur Urol 2002; 42: 498–505.PubMedCrossRefGoogle Scholar
  25. 25.
    Schatzl G, Temml C, Waldmuller J, Thurridl T, Haidinger G, Madersbacher S. A comparative cross-sectional study of lower urinary tract symptoms in both sexes. Eur Urol 2001; 40: 213–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Terai A, Matsui Y, Ichioka K, Ohara H, Terada N, Youshimura K. Comparative analysis of lower urinary tract symptoms and bother in both sexes. Urology 2004; 63: 487–1.PubMedCrossRefGoogle Scholar
  27. 27.
    Jenkins RK, Fultz NH. Functional impairment as a risk factor for urinary incontinence among older Americans. Neurourol Urodyn 2005; 24: 51–5.PubMedCrossRefGoogle Scholar
  28. 28.
    Zorn BH, Montgomery H, Pieper K, et al. Urinary incontinence and depression. J Urol 1999; 102: 82–4.CrossRefGoogle Scholar
  29. 29.
    Stach-Lempinen B, Hakala AL, Laippala P, Lehtinen K, Metsänoja R, Kujansuu E. Severe depression determines quality of life in urinary incontinent women. Neurourol Urodyn 2003; 22: 563–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Steers WD, Lee KS. Depression and incontinence. World J Urol 2001; 19: 351–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Finkelstein MM. Medical conditions, medications, and urinary incontinence. Can Fam Physician 2002; 48: 96–101.PubMedGoogle Scholar
  32. 32.
    Feinberg M. The problems of anticholinergic adverse effects in older patients. Drugs Aging 1993; 3: 335–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Kay G, Granville LJ. Antiumuscarinic agents: implications and concerns in the management of overactive bladder in the elderly. Clin Ther 2005; 27: 127–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Griffiths D. Clinical studies of cerebral and urinary tract function in elderly people with urinary incontinence. Behav Brain Res 1998; 9: 151–5.CrossRefGoogle Scholar
  35. 35.
    Van Straaten EC, Fazekas F, Rostrup E, et al. Impact of white matter hyperintensities scoring method on correlations with clinical data: the LADIS study. Stroke 2006; 37: 836–40.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2007

Authors and Affiliations

  • Maria Nuotio
    • 1
    • 2
    Email author
  • Teuvo L. J. Tammela
    • 3
  • Tiina Luukkaala
    • 2
    • 4
  • Marja Jylhä
    • 2
    • 4
  1. 1.Geriatric Unit, South-Ostrobothnia Hospital DistrictSeinäjoki Central HospitalScinäjoki
  2. 2.Tampere School of Public HealthUniversity of TampereTampere
  3. 3.Department of UrologyTampere University Hospital and Medical School, University of TampereTampere
  4. 4.Research UnitTampere University HospitalTampereFinland

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