title: Nocturia increases the incidence of depressive symptoms: a longitudinal study of the HEIJO-KYO cohort.
abstract: To evaluate the association between nocturia and the incidence of depressive symptoms.
  
  
  
  Of 1 127 participants in the HEIJO-KYO population-based cohort, 866 elderly individuals (mean age 71.5 years) without depressive symptoms at baseline were followed for a median period of 23 months. Nocturnal voiding frequency was logged using a standardized urination diary and nocturia was defined as a frequency of ≥2 voids per night. Depressive symptoms were assessed using the Geriatric Depression Scale.
  
  
  
  During the follow-up period, 75 participants reported the development of depressive symptoms (score ≥6). The nocturia group (n = 239) exhibited a significantly higher hazard ratio (HR) for incident depressive symptoms than the non-nocturia group (n = 627) in the Cox proportional hazard model, which was adjusted for age, gender, alcohol consumption, day length and presence of hypertension and chronic kidney disease (HR 1.69, 95% confidence interval [CI] 1.05-2.72; P = 0.032]. The significance remained after adjustment for sleep disturbances (HR 1.68, 95% CI 1.02-2.75; P = 0.040). Analysis stratified by gender showed that the association between nocturia and the incidence of depressive symptoms was significant in men (HR 2.51, 95% CI 1.27-4.97; P = 0.008) but not in women (HR 1.12, 95% CI 0.53-2.44; P = 0.74).
  
  
  
  Nocturia is significantly associated with a higher incidence of depressive symptoms in the general elderly population, and gender differences may underlie this association.
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Obayashi
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Saeki
authors.affiliation: Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Negoro
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D000368:Aged; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D053158:Nocturia / Q000523:psychology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires
keywords: circadian rhythm; depressive symptoms; gender differences; nocturia; sleep disturbances