Study On Depressive Symptoms And Memory In Elderly Benign Prostatic Hyperplasia Patients With And Without Hypertension:a Real World Study

Part I Study on the multimorbidity and frailty in elderly benign prostatic hyperplasia patients:A real world studyObjective:To investigate the occurrence of multimorbidity and frailty in elderly benign prostatic hyperplasia patients and its influencing factors.Methods:Elderly benign prostatic hyperplasia patients hospitalized in Hefei Hospital Affiliated to Anhui Medical University form January 2018 to February 2021and the Second Hospital Anhui Medical University from January 2012 to December2019 were enrolled in our study.The information of age,marital status and patient's disease were collected.The chronic diseases and patterns of multimorbidity in elderly benign prostatic hyperplasia patients were evaluated.The FRAIL scale was conducted to evaluate the frailty of patients,and the logistic regression model was used to determine the factors associated with multimorbidity and frailty in elderly benign prostatic hyperplasia patients.Results:A total of 1076 elderly benign prostatic hyperplasia patients were enrolled,the prevalence of multimorbidity was 66.26%.The most common multimorbidity were hypertension(44.24%),cerebrovascular disease(22.76%),diabetes mellitus(14.40%)and coronary heart disease(12.64%).The top multimorbidity of three chronic disease were benign prostatic hyperplasia and hypertension and cerebrovascular disease(7.24%),benign prostatic hyperplasia and hypertension and diabetes mellitus(3.43%),and coronary heart disease benign prostatic hyperplasia+hypertension+coronary heart disease(2.13%).Age,smoking,IPSS and nocturia frequency were the risk factor for multimorbidity.The prevalence of non-frailty,pre-frailty and frailty was 25.8%,50.6%and 23.6%,respectively in 178 patients.Age,smoking,IPSS and multimorbidity were the risk factor for frailty in elderly benignprostatic hyperplasia patients,and Cystatin C was correlated positively with frailty(r=0.177,p=0.017).Conclusion:The multimorbidity of chronic disease is very universally in elderly benign prostatic hyperplasia patients,and hypertension is the most common multimorbidity.The pre-frailty and frailty are common in elderly benign prostatic hyperplasia patients.Age,smoking,IPSS and multimorbidity were the risk factor for frailty in elderly benign prostatic hyperplasia patients.Part II Study on the correlation among lower urinary tract symptoms,illness perceptions and depressive symptoms and retrospective memory in elderly benign prostatic hyperplasia patients with and without hypertensionObjective:Lower urinary tract symptoms(LUTS)secondary to benign prostatic hyperplasia(BPH)is one of the most common diseases in aging menand can have negative effects on quality of life and depressive symptoms.This study aimed to exploring whether illness perceptions may mediate the relationship between depressive symptoms and LUTS among BPH patients.Methods:The Patient Health Questionnaire(PHQ-9)for depression,the International Prostate Symptom Score(IPSS)for the severity of LUTS and the brief Illness Perception Questionnaire(B-IPQ)for illness perceptions(IPs)were used among the 160 BPH patients with LUTS.Pearson's correlation test and Hierarchical regression analyses were used to assess the correlations between LUTS,depressive symptoms and IPs.Results:Our study found that the severity of LUTS was associated depressive symptoms and subscales of illness perceptions,meanwhile IPs was associated with the level of education.A positive relationship was found between scores of PHQ9 and the B-IPQ subscales of illness consequences(r=0.875),identity(r=0.777),timeliner=0.667),concern(r=0.870)and emotion(r=0.878),thus a negative correlation was found between scores of PHQ9 and the B-IPQ subscales of illness coherence(r=-0.695),personal control(r=-0.648)and treatment control(r=-0.713).The hierarchical regression analysis showed IPSS and the B-IPQ subscales of illness consequences,concern and emotion were significantly associated with depression,and explained 85.1%of the variance in depressive symptoms(R~2=0.851,p<0.05).Conclusions:The relationship between LUTS and depressive symptoms may be mediated by the negative IPs,including consequences,concern and emotions.Clinicians should not only focus on the symptoms of patients with BPH,but also on the IPs(included consequences,concern and emotions)to improve the depressive symptoms.Part III Study on the correlation among lower urinary tract symptoms,sleep quality,prospective memory and retrospective memory in elderly benign prostatic hyperplasiapatients with and withouthypertensionObjective:To explore the characteristics related to lower urinary tract symptoms,sleep quality,and subjective prospective memory(PM),and subjective retrospective memory(RM),and investigate the relationship between lower urinary tract symptoms and sleep quality,PM and RM in benign prostatic hyperplasia(BPH)patients with lower urinary tract symptomsMethods:BPH patients were asked to complete the International Prostate Symptom Score(IPSS),Pittsburgh Sleep Quality Index(PSQI),and Prospective and Retrospective Memory Questionnaire(PRMQ).Correlations and linear regression models were used to analyze the data.Results:A total of 101 subjects were included in our study,IPSS scores were(13.66±3.69).(1)The PSQI scores were(7.81±4.39),the prevalence of sleep disorder was 38.5%.IPSS,nocturia frequency and duration of LUTS were correlated positively with the seven dimensions of PSQI(included subjective sleep quality,sleep delay,sleep disorder)and the total score.The level of education was the protective factor for sleep disorder(B=-1.769,?=-0.262,p=0.008),the nocturia frequency(B=1.914,?=0.656,p=0.000)and duration of LUTS(B=0.271,?=0.248,p=0.001)of LUTS were risk factor for sleep disorder.(2)The PM scores were(19.79±3.76),and RM scores were(17.95±3.92).The PM scores were correlated positively with IPSS scores(r=0.446),nocturia frequency(r=0.782)and duration of LUTS(r=0.778).The RM scores were correlated positively with IPSS scores(r=0.390),nocturia frequency(r=0.760)and duration of LUTS(r=0.765).The level of education was the protective factor for PM(B=-1.769,?=-0.262,p=0.008),the IPSS(B=0.169,?=0.159,p=0.013),nocturia frequency B=1.163,?=0.460,p=0.000)and duration of LUTS(B=0.310,?=0.327,p=0.000)of LUTS were risk factor for PM.The level of education was the protective factor for RM(B=-1.575,?=--0.258,p=0.009),the nocturia frequency(B=1.076,?=0.408,p=0.000)and duration of LUTS(B=0.380,?=0.385,p=0.000)of LUTS were risk factor for PM.(3)PM and RM were correlated positively with the seven dimensions of PSQI(included subjective sleep quality,sleep delay,sleep disorder)and the total score(p<0.05).IPSS scores,nocturia frequency,duration of LUTS and subjective sleep quality were the risk factor for PM and RM.Conclusion:BPH patients with LUTS report a decreased sleep quality,PM and RM.The level of education is the protective factor for sleep quality,PM and RM,but LUTS is the risk factor for sleep disorder,the subjective sleep quality and LUTS are the risk factor for PM and RM.