Lower urinary tract symptoms (LUTS) and sleep quality: the mediating role of anxiety and depression in middle-aged and older adults from the ardakan cohort study on aging (ACSA).

Background: The present study investigated the prevalence of LUTS and its relationship with sleep quality in Iranian older adult.

Methods: The data used in this cross-sectional study were extracted from the first phase of the Ardakan Cohort Study on Aging (ACSA). The study included 2716 men aged ≥ 50 years living in Ardakan City. The Pittsburg Sleep Quality Index (PSQI) and International Prostatism Symptom Score (IPSS) questionnaires were used to measure sleep quality and LUTS, respectively. Confirmatory Factor Analysis (CFA) was used to examine the relationship between LUTS and sleep quality, considering the mediating role of anxiety and depression.

Results: The average age of the men was 63.3 ± 8.2 years. The prevalence of moderate LUTS was 20.9% (CI: 19.4 - 22.4%), and severe LUTS was 4.4% (CI: 3.7 - 5.3%). A statistically significant positive correlation was observed between sleep quality with LUTS (r = 0.21, P-value < 0.001), depression (r = 0.45, P-value < 0.001), and anxiety (r = 0.40, P-value < 0.001). LUTS leads to poor sleep quality directly (β = 0.08, P-value = 0.03) and indirectly, considering the mediating role of depression and anxiety factors (β = 0.25, P-value = 0.007).

Conclusion: The prevalence of LUTS among middle-aged and older adults in Ardakan city was lower compared to similar populations elsewhere. Additionally, LUTS affects sleep quality in individuals over 50 both directly and indirectly through anxiety and depression.