To evaluate risk factors of deterioration of lower urinary tract symptoms  in elderly  men by a community-based, prospective longitudinal cohort study.

In a suburban area in Korea, 1514 subjects aged ≥45 years were randomly selected by systematic sampling. A total of 918 elderly subjects were enrolled in this in-depth clinical study in 2004. Of these, 547 participants were followed-up for 3 years. Standard questionnaires were administered face-to-face by trained interviewers. After excluding females, 224 male participants with complete data, including transrectal ultrasonography, were included in the final analysis. Lower urinary tract symptoms were diagnosed using the International Prostate Symptom Score defined as ≥8 points at baseline. Symptom deterioration was defined as >8 points during 3 years.

Symptom prevalence increased to 13.1%,  and the mean International Prostate Symptom Score increased by 2.6 points during 3 years. After adjusting for confounders, smoking history of ≥50 pack-years was an independent risk factor for symptom deterioration and storage sub-symptoms, compared with non-smokers (3.1 and 5.1 odds, respectively). Physical activity had a protective effect for voiding sub-symptoms. High daily protein intake exacerbated the storage symptoms. However, alcohol intake was not associated with symptom deterioration.

To our knowledge, there have been a few study that investigated the risk factors of deterioration of LUTS in longitudinal single cohort study.  In our community-based, prospective longitudinal cohort study, smoking, physical activity and protein intake were strongly associated with LUTS deterioration.

The symptom prevalence among elderly men living in a suburban area increased to 13.1%, and the International Prostate Symptom Score increased by 2.6 points during 3 years. Smoking history, physical activity, and protein intake were associated with symptom deterioration. However, there was no significant association with alcohol intake and symptom deterioration.