Lower Urinary Tract Symptoms Are Associated with Increased Risk of Dementia among the Elderly: A Nationwide Study.
Studies show a strong association between dementia and lower urinary tract symptoms (LUTS). The aim of this study was to investigate whether LUTS are a risk factor for cognitive impairment. We enrolled 50-year-old and older subjects with LUTS (LUTS([+])) (n = 6801) and controls without LUTS (LUTS([-])) (n = 20,403) from Taiwan's National Health Insurance Research Database. LUTS, dementia, and other confounding factors are defined by International Classification of Diseases, Ninth Revision, Clinical Modification Codes. Participants were recruited from 2000 to 2004 and then followed up until death or the end of 2011. The outcome was the onset of dementia, which was assessed using Poisson regression analysis, Cox hazards models, and Kaplan-Meier survival curves. The incidence of dementia was significantly higher in the LUTS([+]) group than in the LUTS([-]) group (124.76 versus 77.59/1000 person-years). The increased risk of dementia related to LUTS remained significant after adjustment for potential confounders (adjusted hazard ratio (AHR): 1.61, 95% confidence interval (CI) 1.47-1.76, P < 0.0001) and higher than that related to cerebrovascular disease (AHR: 1.43, 95% CI 1.26-1.61, P < 0.0001). The outcome suggests the need for early screening and appropriate intervention to help prevent cognitive impairment of patients with LUTS.
Department of Geriatrics and Gerontology, Chi Mei Medical Center, 901 Zhong-Hua Road, Yongkang District, Tainan 710, Taiwan ; Department of Family Medicine, Chi Mei Medical Center, Tainan 710, Taiwan.
Chi-Hsiang
CH
Chiang
Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan ; Division of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan 710, Taiwan ; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan.
Ming-Ping
MP
Wu
Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan ; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan.
Chung-Han
CH
Ho
Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan ; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan.
Shih-Feng
SF
Weng
Department of Emergency Medicine, Chi Mei Medical Center, Tainan 710, Taiwan ; Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan ; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
Chien-Cheng
CC
Huang
Department of Geriatrics and Gerontology, Chi Mei Medical Center, 901 Zhong-Hua Road, Yongkang District, Tainan 710, Taiwan ; Department of Family Medicine, Chi Mei Medical Center, Tainan 710, Taiwan.
Wan-Ting
WT
Hsieh
Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan ; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan.
Ya-Wen
YW
Hsu
Department of Geriatrics and Gerontology, Chi Mei Medical Center, 901 Zhong-Hua Road, Yongkang District, Tainan 710, Taiwan ; Department of Family Medicine, Chi Mei Medical Center, Tainan 710, Taiwan.
Ping-Jen
PJ
Chen
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology; D015140:Dementia, Vascular / Q000175:diagnosis / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014551:Urinary Tract / Q000503:physiopathology*