Hypothesis / aims of study
Anxiety is reported in up to 48% of individuals with OAB and has detrimental impacts on quality of life [1, 2]. Although cross-sectional research indicates a positive relationship between anxiety and OAB symptoms, both anxiety and lower urinary tract symptoms (LUTS), such as urinary urgency, vary in daily life and are not well-captured at a single time point. This study applied ecological momentary assessment (EMA) to examine concurrent and lagged relationships between anxiety and LUTS among individuals with and without OAB.
Study design, materials and methods
The current research utilizes data from two studies. For each study, individuals with active OAB symptoms (OAB v3≥4) and healthy controls (HC) were recruited to complete a series of daily prompts evaluating affective symptoms (e.g. anxiety) and LUTS (e.g. urgency) by rating each on a 0-10 numeric rating scale (NRS). Participants completed measures at 4 daily prompts over 7 days for each study. Because participants could complete one or both studies, up to 28 (one study - 7 days) or 56 (both studies - 14 days) diary entries were available for analysis. Multilevel models (MLMs) with measurement occasions (Level 1) nested within individuals (Level 2) were used to predict contemporaneous and subsequent urinary urgency via anxiety. To model effects of anxiety on subsequent urinary urgency, anxiety at time t was used to predict urinary urgency at the next timepoint (t+1), while controlling for time t urinary outcomes.
Results
363 participants (277 OAB, 86 HC) (M age = 47.36, 67.8% White) completed baseline measures and 325 completed EMA. Anxiety concurrently predicted urinary urgency (b = .11, p < .0001). Anxiety also predicted urgency at the following timepoint (b = .045, p = .014). However, this effect was no longer significant when controlling for current urinary urgency, b = .03, p = .08.
Interpretation of results
These results suggest that anxiety is related to increased urinary urgency in individuals with and without OAB. Anxiety appears to have both concurrent and delayed relationships with urinary urgency. However, the relationship between anxiety and urgency at the next time point was attenuated after controlling for current urgency, suggesting that the relationship may be explained by a shared risk profile characterized by elevated anxiety and urgency, rather than an independent impact of anxiety on later urgency.