The status of health-related quality of life among older adults with overactive bladder: a cross-sectional analysis of the Yamagata Cohort Study in Japan

Overactive bladder (OAB) is prevalent among older adults and may substantially affect health-related quality of life (HRQoL). This study aimed to describe HRQoL status among community-dwelling older adults with OAB and examine the relationship between OAB symptom severity and HRQoL.

A cross-sectional analysis was conducted using data from 12,212 participants aged ≥ 65 years in the Yamagata Cohort Study (2021–2022). Multiple imputation was used to handle missing data. OAB was assessed using the OABSS (total score ≥ 3 and urgency score ≥ 2), and HRQoL was measured using the EQ-5D-5L utility score and EQ VAS. Multiple regression analyses were performed, adjusting for age, sex, BMI, and comorbidities.

Participants with OAB (n = 2,864, 27.9%) had significantly lower EQ-5D-5L utility scores (β = − 0.057; 95% CI − 0.063, − 0.052) and EQ VAS scores (β = − 4.882; 95% CI − 5.579, − 4.184) compared to those without OAB. This disutility exceeded the minimally important difference. HRQoL declined progressively with increasing OAB severity, with the most pronounced impact observed in the 65–69-year age group. Urgency and urgency urinary incontinence showed the strongest negative relationships with HRQoL. The self-care dimension was most affected (OR 2.457; 95% CI 2.115, 2.853).

OAB is prevalent among community-dwelling older Japanese adults and is associated with clinically meaningful HRQoL reductions. These findings suggest the importance of early detection and severity-based, symptom-specific management, particularly targeting urgency and incontinence (e.g., β3-stimulants, behavioral therapy).