Clinical depression common in elderly men with LUTS

Oct 14 2013

A study of Chinese elderly men with moderate-to-severe lower urinary tract symptoms (LUTS) shows that they are significantly more likely to experience clinical depression than men with milder symptoms.

With over two-thirds of men with mild-to-moderate LUTS in their study having clinically relevant depressive symptoms, the researchers say that greater awareness of, and even screening for, depression is needed in these patients.

Samuel Wong (University of Hong Kong, China) and colleagues followed up 1726 men, aged an average of 72.1 years, over 2 years. They found that the 686 (39.7%) men with moderate or severe LUTS symptoms at baseline according to the International Prostatic Symptoms Score were 2.5-fold more likely to have clinically relevant depressive symptoms at year 2 than men with no or mild symptoms (67.2 vs 32.8%), after adjusting for confounders.

Other factors associated with depression on the Geriatric Depression Scale at follow-up included depression at baseline, having diabetes, and experiencing more than one stressful life event during the course of the study.

Writing in PLoS One, Wong et al say theirs is the first longitudinal study exploring the relationship between LUTS and depression in Asian men.

“There are several mechanisms in which LUTS can lead to manifesting depressive symptoms in Chinese elderly men, mainly due to the demoralization of having LUTS,” the team comments.

They add that previous research shows that men with LUTS are discouraged from performing normal daily activities – a risk factor for depression. Meanwhile, sexual dysfunction, social embarrassment, and loss of sleep due to nocturia could also contribute to the relationship.

The authors say that given evidence of a reciprocal association between LUTS and depression, treatment of one could induce a positive feedback cycle, such that “any intervention that improves the LUTS situation may also be beneficial towards reducing depressive symptoms, which may then feed back to improve the LUTS situation.”

They conclude: “Further intervention studies need to be conducted to confirm this hypothesis, which can have important public health impact to the elderly suffering from both urological and psychological problems.”

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