Lower Urinary Tract Symptoms and Cognitive Impairment Among Participants in the REGARDS Cohort Study

To understand cross-sectional associations between lower urinary tract symptoms (LUTS) and specific cognitive domains, we examined cognitive performance in older adults with and without LUTS.

The study comprised a subset of Black and White participants, aged 45 and older, enrolled in the REasons for Geographic and Racial Differences in Stroke (REGARDS) national, longitudinal cohort study 2003-2007. Computer-assisted telephone interviews were conducted for follow-up every 6 months including an established cognitive battery: Six-Item Screener (SIS) for cognitive impairment, animal naming, letter F naming, word list learning, and delayed recall for verbal fluency/executive function and verbal memory. Validated LUTS questionnaires were administered beginning in 2020 at 6-month intervals. Separate linear and logistic regression models for men and women estimated associations between LUTS and cognitive battery scores, adjusting for covariates.

From the 10,464 participants (6026 women, 4438 men), 70% of women reported LUTS (mean age 69 ± 8 years) versus 62% of men (mean age 63 ± 7 years). More Black men reported LUTS compared to White men, 69% versus 59% (p < 0.001), respectively, without differences among Black and White women. Men and women with LUTS had decreased odds of being cognitively intact based on the SIS, OR 0.65, 95% CI 0.50, 0.85 and OR 0.64, 95% CI 0.46, 0.78, respectively. Men with LUTS had lower scores for Animal Naming (β -0.42, 95% CI -0.75, -0.08) and Delayed Recall (β -0.18, 95% CI -0.30, -0.05). Women with LUTS had lower test scores for Letter F Naming (β -0.29, 95% CI -0.55, -0.04), Word List Learning (β -0.40, 95% CI -0.68, -0.11) and Delayed Recall (β -0.13, 95% CI -0.25, -0.02).

Older adults with LUTS have subtle differences in cognitive function, especially in new learning, verbal memory, and verbal fluency/executive function that should be considered in treatment decisions.