Coexistence of urinary incontinence and major depressive disorder with health-related quality of life in older Americans with and without cancer.
OBJECTIVE
This study evaluates the prevalence and factors associated with major depressive disorder (MDD) in a population of cancer survivors and the impact of co-occurring MDD and urinary incontinence (UI) on health-related quality of life (HRQOL).


METHODS
The prevalence of MDD risk among cancer survivors (breast, prostate, bladder, colorectal, lung, and endometrial/uterine cancers) and those without cancer was estimated using the Surveillance, Epidemiology and End Results Program-Medicare Health Outcomes Survey (SEER-MHOS) linked database (n = 9,282 with cancer/n = 289,744 without cancer). Risk for MDD was measured using three items from the Diagnostic Interview Schedule, and HRQOL was measured by the SF-36. UI was defined as self-reported leakage of urine causing a problem in previous 6 months. Factors associated with MDD were investigated using logistic regression, and the impact of co-occurring MDD and UI on HRQOL scores was determined using linear regression.


RESULTS
The prevalence of MDD risk ranged from 19.2 % for prostate to 34.1 % for lung. Lung cancer diagnosis was associated with risk of MDD. Being ≥5 years from diagnosis was associated with decreased risk of MDD (prevalence odds ratio (POR) = 0.82, 95 % confidence interval (95 % CI) 0.71, 0.95). The coexistence of both UI and MDD was associated with a decrease across HRQOL subscales; including 40 points on role-emotional (RE) score.


CONCLUSIONS
Cancer survivors reporting co-occurrence of UI and MDD experienced significant decrements in HRQOL.


CONCLUSIONS
Understanding the combined effect of UI and MDD may help clinicians to better recognize and alleviate their effects on cancer survivors' HRQOL.
Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599-7435, USA, whitea@unc.edu.
Alexandra J
AJ
White
Bryce B
BB
Reeve
Ronald C
RC
Chen
Angela M
AM
Stover
Debra E
DE
Irwin
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000401:mortality*; D015995:Prevalence; D011788:Quality of Life; D018426:SEER Program; D017741:Survivors; D014549:Urinary Incontinence / Q000453:epidemiology*