Effect of Urgency Symptoms on the Risk of Depression in Community-Dwelling Elderly Men

Purpose: To evaluate the association of a specific type of lower urinary tract symptom ( LUTS) and the depression in community-dwelling elderly Korean men. Materials and Methods: A total of 392 men aged 65 years or older, who completed urological and psychiatric evaluations as a participant of the Korean Longitudinal Study on Health and Aging, were included. From each subject, an interview on the demographic characteristics and medical history, IPSS, and psychiatric questionnaire were taken. Subjects were divided into two groups; depression and euthymic. Subjects with IPSS subscore more than 3 points was considered 'high' subscore. IPSS subscores were compared between the two groups, and the relationship between depression and LUTS severity was assessed. Results: The mean age of the subjects was 75, and 6.4% of the subjects were diagnosed to have major depressive disorders. The depression group showed higher IPSS scores than the euthymic group ( 16.1 +/- 9.9 vs. 11.6 +/- 8.6, p=0.01). IPSS subscores of question 1 ( incomplete empty), question 3 ( intermittency), question 4 ( urgency) and question 6 ( straining to void) were higher in the depression group compared with the euthymic group. Chi-square test revealed subjects with high IPSS 1, 3, 4, and 6 score were associated with depression, but multivariate analysis identified only high IPSS question 4 as a significant prognostic factor for depression. Conclusions: Elderly population with depression is more likely to have more severe LUTS than population without depression. Among the urinary symptoms, urgency was strongly associated with depression. Patients with moderate to severe LUTS and especially urgency may need their mental health status evaluation.