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05-06-2012 | Internal medicine | Article

Risk factors established for new-onset OAB


Free abstract

MedWire News: Older individuals are at an increased risk for developing an overactive bladder (OAB) if they are male, experiencing voiding symptoms, or suffering from depression, report researchers.

The three factors independently predicted new-onset OAB in men and women aged 65 years and older who participated in a longitudinal study specifically designed to seek out risk factors for the condition.

"Many case-control studies have evaluated the association of diet, lifestyle, and clinical factors with OAB … but they could not reveal the true risk factors influencing the onset of OAB because they were not longitudinal studies," say Akihide Hirayama (Nara Medical University, Japan) and team.

Hirayama's study, which was conducted in Nara Prefecture in Japan, included 3685 community-based individuals who provided baseline and 1-year follow-up information in response to self-administered questionnaires including the International Prostate Symptom Score (IPSS), the OAB symptoms score (OABSS), and the Geriatric Depression Scale.

The team's data analysis showed that being male, having voiding symptoms at baseline, and having depression at baseline were all significant predictors for developing OAB 1 year later, at odds ratios of 2.0, 1.1, and 1.8, respectively.

The risk for OAB also increased with severity of voiding symptoms, with 24.5% of patients with an OABSS sum of 10 or higher affected by OAB.

Bladder outlet obstruction has previously been shown to induce OAB, notes the team. "Not only bladder outlet obstruction, but also a weak detrusor and low-voided volumes cause deteriorating voiding symptoms."

The researchers say the effect of gender on OAB risk may be due to the difference in anatomy and lifestyle habits between men and women. And the fact that depression-influenced OAB risk may be linked to serotonergic function, as previous research has shown that "reducing the amount of serotonin in the brains of experimental animals triggered urinary frequency and caused detrusor overactivity," they explain.

The authors say it will be necessary to evaluate whether treatment of older patients with voiding symptoms or depression controls the new onset of OAB.

By Sally Robertson

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