Nocturia Increases the Incidence of Depressive Symptoms: A Longitudinal Study of the HEIJO-KYO Cohort

Previous epidemiological studies have suggested a cross-sectional association between nocturia and depressive symptoms. The purpose of this study was to evaluate the association between nocturia and the incidence of depressive symptoms.

Of 1127 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 void 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 males (HR, 2.51; 95% CI, 1.27-4.97; P = 0.008) but not in females (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. This article is protected by copyright. All rights reserved.

BJU international. 2017 Jan 27 [Epub ahead of print]

Kenji Obayashi, Keigo Saeki, Hiromitsu Negoro, Norio Kurumatani

Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan., Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.