Prevalence and burden of overactive bladder in the United States.
BACKGROUND
the National Overactive BLadder Evaluation (NOBLE) Program was initiated to better understand the prevalence and burden of overactive bladder in a broad spectrum of the United States population.


OBJECTIVE
to estimate the prevalence of overactive bladder with and without urge incontinence in the US, assess variation in prevalence by sex and other factors, and measure individual burden.


METHODS
US national telephone survey using a clinically validated interview and a follow-up nested study comparing overactive bladder cases to sex- and age-matched controls.


METHODS
noninstitutionalized US adult population.


METHODS
a sample of 5,204 adults >/=18 years of age and representative of the US population by sex, age, and geographical region.


METHODS
prevalence of overactive bladder with and without urge incontinence and risk factors for overactive bladder in the US. In the nested case-control study, SF-36, CES-D, and MOS sleep scores were used to assess impact.


RESULTS
the overall prevalence of overactive bladder was similar between men (16.0%) and women (16.9%), but sex-specific prevalence differed substantially by severity of symptoms. In women, prevalence of urge incontinence increased with age from 2.0% to 19% with a marked increase after 44 years of age, and in men, increased with age from 0.3% to 8.9% with a marked increase after 64 years of age. Across all age groups, overactive bladder without urge incontinence was more common in men than in women. Overactive bladder with and without urge incontinence was associated with clinically and significantly lower SF-36 quality-of-life scores, higher CES-D depression scores, and poorer quality of sleep than matched controls.


CONCLUSIONS
the NOBLE studies do not support the commonly held notion that women are considerably more likely than men to have urgency-related bladder control problems. The overall prevalence of overactive bladder does not differ by sex; however, the severity and nature of symptom expression does differ. Sex-specific anatomic differences may increase the probability that overactive bladder is expressed as urge incontinence among women compared with men. Nonetheless, overactive bladder, with and without incontinence, has a clinically significant impact on quality-of-life, quality-of-sleep, and mental health, in both men and women.
Stewart
W F
WF
Department of Epidemiology, Johns Hopkins University, 615 North Wolfe Street, Room 6039E, Baltimore, MD 21205, USA. wstewart@jhsph.edu
Van Rooyen
J B
JB
Cundiff
G W
GW
Abrams
P
P
Herzog
A R
AR
Corey
R
R
Hunt
T L
TL
Wein
A J
AJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D017281:Cost of Illness; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D001745:Urinary Bladder Diseases / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D014549:Urinary Incontinence / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology