Progression of Lower Urinary Tract Symptoms in Older Men: A Community Based Study

J. Kellogg Parsons, Timothy J. Wilt, Patty Y. Wang, Elizabeth Barrett-Connor, Douglas C. Bauer, Lynn M. Marshall

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Purpose: Lower urinary tract symptom progression in community dwelling older men is not well described. Materials and Methods: We evaluated 5,697 participants in Osteoporotic Fractures in Men, a prospective cohort study of community dwelling men 65 years old or older. We characterized lower urinary tract symptoms using the American Urological Association symptom index at 2 time points, including at study entry and at 2-year followup. Progression was examined in the overall cohort and within baseline symptom strata (symptom index 7 or less and 8 or greater) using descriptive statistics. Results: At baseline mean ± SD age was 73.5 ± 5.8 years and mean symptom index score was 8.3 ± 6.3 points. Mean and median total symptom index increased during followup by 1.1 ± 5.0 and 1.0 points, respectively. Of the 3,092 men with a symptom index of 7 points or less at baseline 883 (29%) reported lower urinary tract symptoms progression (8 points or greater) at followup. The incidence of lower urinary tract symptom progression increased with advancing baseline age. Of the 2,605 men with a symptom index of 8 points or greater at baseline 622 (24%) reported progression of at least 4 points at followup. Of the 2,200 men with a baseline symptom index of 7 points or less and no history of benign prostatic hyperplasia or lower urinary tract symptom treatment 94% remained untreated, 2% reported benign prostatic hyperplasia surgery and 4% reported medication use at followup. Conclusions: Up to 29% of community dwelling older men with no or mild lower urinary tract symptoms will have clinically significant lower urinary tract symptoms within 2 years. These data help elucidate the natural history of lower urinary tract symptoms in the community and provide useful data to design clinical trials of lower urinary tract symptom prevention.

Original languageEnglish (US)
Pages (from-to)1915-1920
Number of pages6
JournalJournal of Urology
Issue number5
StatePublished - May 2010

Bibliographical note

Funding Information:
Supported by the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute on Aging, National Center for Research Resources, National Institute of Health Roadmap for Medical Research Grants U01 AR45580 , U01 AR45614 , U01 AR45632 , U01 AR45647 , U01 AR45654 , U01 AR45583 , U01 AG18197 , U01-AG027810 and UL1 RR024140 , Department of Defense Physician Research Training Award PC073412 (JKP), and National Cancer Institute Awards CA32102 and P30 CA23100-23 (JKP).

Copyright 2010 Elsevier B.V., All rights reserved.


  • epidemiology
  • prostate
  • prostatic hyperplasia
  • risk
  • urination disorders


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