Articles

Obesity Increases and Physical Activity Decreases Lower Urinary Tract Symptom Risk in Older Men: The Osteoporotic Fractures in Men Study eulogo1

By: J. Kellogg Parsonsa b c lowast , Karen Messerd e, Martha Whited, Elizabeth Barrett-Connore, Douglas C. Bauerf , Lynn M. Marshallg h for the Osteoporotic Fractures in Men (MrOS) Research Group and the Urologic Diseases in America Project.

Published online: 01 December 2011

Keywords: LUTS, Epidemiology, BPH, Benign prostatic hyperplasia, Obesity, Exercise, Physical activity, Prostate, IPSS

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Abstract

Background

Two potential targets for preventing chronic lower urinary tract symptoms (LUTS) in older men are obesity and physical activity.

Objective

To examine associations of adiposity and physical activity with incident LUTS in community-dwelling older men.

Design, setting, and participants

The Osteoporotic Fractures in Men Study (MrOS) is a prospective cohort of men ≥65 yr of age. MrOS participants without LUTS and a history of LUTS treatment at baseline were included in this analysis.

Measurements

Adiposity was measured with body mass index (BMI), physical activity with the Physical Activity Scale for the Elderly (PASE) and self-report of daily walking, and LUTS with the American Urological Association Symptom Index.

Results and limitations

The mean age (standard deviation [SD]) of the 1695 participants was 72 (5) yr at baseline. At a mean (SD) follow-up of 4.6 (0.5) yr, 524 (31%) of men reported incident LUTS. In multivariate analyses, compared with men of normal weight at baseline (BMI <25kg/m2), overweight (BMI: 25.0–29.9kg/m2) and obese (≥30kg/m2)men were 29% (adjusted odds ratio [ORadj]: 1.29; 95% confidence interval [CI], 1.00–1.68) and 41% (ORadj: 1.41; 95% CI, 1.03–1.93) more likely to develop LUTS, respectively. Men in the highest quartile of physical activity were 29% (ORadj: 0.71; 95% CI, 0.53–0.97) and those who walked daily 20% (ORadj: 0.80; 95% CI, 0.65–0.98) less likely than their sedentary peers to develop LUTS, adjusting for BMI. The homogeneous composition of MrOS potentially diminishes the external validity of these results.

Conclusions

In older men, obesity and higher physical activity are associated with increased and decreased risks of incident LUTS, respectively. Prevention of chronic urinary symptoms represents another potential health benefit of exercise in elderly men.

Take Home Message

In men ≥65 yr of age, daily walking and exercise potentially prevent lower urinary tract symptoms, even among those who are obese.

Keywords: LUTS, Epidemiology, BPH, Benign prostatic hyperplasia, Obesity, Exercise, Physical activity, Prostate, IPSS.

Footnotes

a Division of Urology, University of California San Diego, San Diego, CA, USA

b Urologic Cancer Unit, Moores UCSD Cancer Center, La Jolla, CA, USA

c Department of Surgery, San Diego Veterans Affairs Medical Center, La Jolla, CA, USA

d Division of Biostatistics, Moores UCSD Cancer Center, La Jolla, CA, USA

e Department of Family and Preventive Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA

f Department of Medicine, University of California San Francisco, San Francisco, CA, USA

g Department of Medicine, Bone and Mineral Unit, Oregon Health and Science University, Portland, OR, USA

h Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, OR, USA

lowast Corresponding author. c/o Leslie Parker, UCSD Division of Urology, 200 West Arbor Drive #8897, San Diego, CA 92103-8897, USA. Tel. +1 619 543 2630; Fax: +1 619 543 6573.

z.star Please visit www.eu-acme.org/europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically.