title: Alcohol, Smoking, Physical Activity, Protein, and Lower Urinary Tract Symptoms: Prospective Longitudinal Cohort.
abstract: OBJECTIVE
  To evaluate risk factors for deterioration of lower urinary tract symptoms (LUTS) in elderly men in a community-based, prospective longitudinal cohort study.
  
  
  METHODS
  In a suburban area in Korea, 1,514 subjects aged ≥45 years were randomly selected by systematic sampling. A total of 918 elderly subjects were enrolled in this in-depth clinical study in 2004. Of these, 547 participants were followed up for 3 years and the data was analyzed in 2014. Standard questionnaires were administered face-to-face by trained interviewers. After excluding women, 224 male participants with complete data including transrectal ultrasonography were included in the final analysis. LUTS were diagnosed using the International Prostate Symptom Score (IPSS) questionnaire. Symptom deterioration was defined as a score of ≥8 points during the 3-year follow-up period.
  
  
  RESULTS
  LUTS prevalence increased to 13.1% and the mean IPSS increased by 2.6 points during the 3-year period. After adjusting for confounders, a smoking history of ≥50 pack-years was an independent risk factor for deterioration of LUTS and storage subsymptoms compared with no history of smoking (3.1 and 5.1 odds, respectively). Physical activity had a protective effect on voiding subsymptoms. However, high protein diet and alcohol intake were not associated with LUTS deterioration.
  
  
  CONCLUSIONS
  The LUTS prevalence among elderly men living in a suburban area increased to 13.1% and the IPSS increased by 2.6 points during the 3-year period. A history of heavy smoking, low physical activity, and high protein intake were associated with LUTS deterioration. However, there was no significant association between alcohol intake and LUTS deterioration.
authors.affiliation: Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Choo
authors.affiliation: Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Jun Hyun
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Tae Young
authors.initials: TY
authors.lastname: Shin
authors.affiliation: Department of Urology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Kyungtae
authors.initials: K
authors.lastname: Ko
authors.affiliation: Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Cho
authors.affiliation: Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
authors.forename: Sang Kon
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Lee
keywords: Dietary Proteins; Disease Progression; Lower Urinary Tract Symptoms; Motor Activity; Smoking