PREVALENCE, SEVERITY, AND HEALTH CORRELATES OF LOWER URINARY TRACT SYMPTOMS AMONG OLDER MEN: THE MrOS STUDY BRENT C. TAYLOR, TIMOTHY J. WILT, HOWARD A. FINK, LORI C. LAMBERT, LYNN M. MARSHALL, ANDREW R. HOFFMAN, TOMASZ M. BEER, DOUGLAS C. BAUER, JOSEPH M. ZMUDA, AND ERIC S. ORWOLL, FOR THE OSTEOPOROTIC FRACTURES IN MEN (MrOS) STUDY RESEARCH GROUP ABSTRACT Objectives. To describe the prevalence, severity, and health correlates of lower urinary tract symptoms (LUTS) in older community-dwelling U.S. men. Methods. We performed a cross-sectional analysis from a cohort study recruited from six U.S. clinical centers. This analysis included 5284 men without a history of prostate cancer who were at least 65 years of age. Participants completed questionnaires regarding the presence and severity of LUTS, including the American Urological Association Symptom and Bother indexes. Health status measures included the Medical Outcomes Survey SF-12 and self-rated health and instrumental activities of daily living. Results. LUTS were absent in 2.3%, mild in 51.6%, moderate in 39.6%, and severe in 6.6%. Dissatisfaction with the urinary symptoms increased with LUTS severity (P 0.001); 19.8% of moderate and 58.1% of men with severe LUTS reported feeling mostly unsatisfied to terrible with their present urinary symptoms. The prevalence, severity, and dissatisfaction with LUTS increased with age. Men reporting moderate or severe LUTS were 1.41-fold (95% confidence interval 1.23 to 1.61) and 1.51-fold (95% confidence interval 1.23 to 1.85) more likely to rate their overall health quality as fair to very poor for their age instead of good to excellent, even after controlling for age and comorbid conditions. Increased LUTS also was independently associated with increased impairment in instrumental activities of daily living and poorer SF-12 scores. Conclusions. Moderate-to-severe LUTS is common in community-dwelling elderly U.S. men. In this study, LUTS severity was associated with poorer health quality and a greater prevalence of an inability to perform activities of daily living. The association of LUTS severity with poor health warrants increased clinical attention. UROLOGY 68: 804–809, 2006. © 2006 Elsevier Inc. L ower urinary tract symptoms (LUTS), fre- quently attributed to benign prostatic hyper- plasia (BPH), increase with age and occur in most elderly men. 1 Detailed knowledge of how the pres- ence and severity of LUTS is related to the health status of older men, particularly within the United The Osteoporotic Fractures in Men (MrOS) Study was sup- ported by National Institutes of Health funding; the following institutes provided support: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute on Aging, and National Cancer Institute under the following grant numbers: UO1 AR45580, UO1 AR45614, UO1 AR45632, UO1 AR45647, UO1 AR45654, UO1 AR45583, UO1 AG18197, and M01 RR000334. B. C. Taylor, T. J. Wilt, and H. A. Fink were supported with funding from the Veterans Health Administration Office of Health Services Research and Development. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Vet- erans Affairs. From the Center for Chronic Disease Outcomes Research and the Geriatric Research Education and Clinical Center, Veterans Affairs Medical Center; Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota School of Medicine, Minneapolis, Minnesota; Oregon Health and Science University, Portland, Oregon; Veterans Affairs Palo Alto Health Care System and Stanford University Medical Center, Palo Alto, California; Departments of Medicine and Epidemiol- ogy and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California; and Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania Reprint requests: Brent C. Taylor, Ph.D., M.P.H., Center for Chronic Disease Outcomes Research (152/2E), Minneapolis Vet- erans Affairs Medical Center, 1 Veterans Drive, Minneapolis, MN 55417. E-mail: brent.taylor2@va.gov Submitted: January 3, 2006, accepted (with revisions): April 20, 2006 ADULT UROLOGY © 2006 ELSEVIER INC. 0090-4295/06/$32.00 804 ALL RIGHTS RESERVED doi:10.1016/j.urology.2006.04.019