In a recent study published in the journal Scientific Reports, researchers in China examined the trends and prevalence of overactive bladder (OAB) among adult men in the United States of America (US) from 2005 to 2020. They found that the overall prevalence of OAB in US adult men increased from 11.3% in 2005–2008 to 14.5% in 2015–2020 and showed significant associations with factors such as age, race, obesity, diabetes, and other chronic conditions.
Study: Prevalence and trends in overactive bladder among men in the United States, 2005–2020. Image Credit: staras / Shutterstock
Background
OAB significantly affects the quality of life, physical health, and mental health of men and women. It is associated with substantial economic burdens. Characterized by symptoms such as urinary urgency, increased frequency, nocturia, and sometimes urgency urinary incontinence (UUI), OAB's prevalence varies globally. The EPIC (short for European Prospective Investigation into Cancer and Nutrition) study estimated an 11.8% prevalence in five countries, while the OAB-POLL study found an 8% prevalence in US men and 20% in US women. Prevalence rates in Asia and China were reported to be 20.8% and 23.9%, respectively. Variations in prevalence are due to geographic distribution, epidemiological methods, study designs, and definitions. Factors like age, lifestyle, nutritional status, socioeconomic status, and comorbidities are also hypothesized to be associated with OAB, though its pathogenesis remains unclear. In the present study, researchers used data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2020 to evaluate the prevalence and trends of OAB among adult US men. Further, they aimed to identify the association of OAB with sociodemographic features, body mass index (BMI), chronic comorbidities, and lifestyles.
About the study
The NHANES collected health data from the US noninstitutionalized population using a multistage probability sample design to ensure optimal representation. The surveys, spanning from 1999 to March 2020, aimed to provide comprehensive health and nutrition information. A total of 18,386 male adults aged 20 years and above, with complete data, were included in the present study. Data on OAB symptoms were collected using the Kidney Conditions-Urology (KIQ_U) questionnaire. Two questions assessed UUI severity, while one question evaluated nocturia frequency. Additionally, the OAB Symptom Score questionnaire (≥3) was used to identify OAB.
Data were extracted on various factors including age (20–39, 40–59, ≥60 years), race or ethnicity (Hispanic, non-Hispanic Black, non-Hispanic White, Asian, and other), education level (high school, lesser than high school, or greater than high school), family poverty ratio, BMI (<25 kg/m², 25–30 kg/m², ≥30 kg/m²), smoking status, hypertension, diabetes, depression, sleep time, sleep disorder, chronic conditions, recreational activity levels, healthy diet, general health condition, food security, and health insurance status.
The analysis involved the use of descriptive statistical methods, chi-square tests for prevalence differences, odds ratios (ORs), and weighted logistic regression.
Results and discussion
No significant differences were found in most survey variables, including age and race/ethnicity. The overall prevalence of OAB among US men increased from 11.3% in the period 2005–2008 to 11.7% in the period 2009–2014, and then rose significantly to 14.5% in the period 2015–2020. Notably, the prevalence rose from 9.7% to 13.5% for men aged 40–59 years and 3.6% to 4.5% for those aged 20–39 years, while it remained stable for men aged ≥60 years. Based on race and ethnicity, an increase in OAB prevalence was found in non-Hispanic White men (from 11.1% to 14.5%), non-Hispanic Black men (from 15.4% to 20.3%), and Hispanic men (from 10.5% to 12.3%). Among BMI groups, the OAB prevalence was found to increase from 11.0% to 14.2% in overweight men and from 13.2% to 16.3% in obese men, remaining stable for those with a BMI lower than 25 kg/m2.
The multivariate logistic regression analysis showed that the prevalence of OAB was higher in men aged ≥60 years (OR 7.21) and men aged 40–59 years (OR 2.63) compared to men aged 20–39 years. Hispanic and non-Hispanic Black men showed a higher prevalence than non-Hispanic White men. Higher OAB prevalence was also associated with diabetes, depression, sleep disorders, chronic conditions, mild and moderate recreational activity, poorer health, and unsafe food. Conversely, higher educational levels and better family poverty ratios were found to be linked to a lower prevalence of OAB.
The NHANES design of the study ensured a representative sample and high-quality data collection for the US population, thereby strengthening the study. However, the study is limited by its reliance on self-reported OAB data without comprehensive clinical assessments, potential recall biases, and the exclusion of institutionalized individuals.
Conclusion
In conclusion, the current prevalence of OAB in US men is high, with a significant increase over the past two decades, particularly among men aged 40–59 years, non-Hispanic White and Black, and those who are overweight or obese. In the future, studies should focus on addressing OAB disparities across sociodemographic subgroups and investigating factors driving the rising trends in specific OAB subtypes to help prevent and address this global health concern.
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