Correlation between overactive bladder symptom score and neuropsychological parameters in Alzheimer’s disease patients with lower urinary tract symptom

Abstract

Purpose To examine an association between the overactive bladder symptom score (OABSS) and neuropsychological parameters. Moreover, we investigate the factors that affect each item in the questionnaire.Materials and Methods A total of 376 patients (males: 184; females: 192) with probable Alzheimer’s disease (AD) were recruited. Cognitive testing was conducted using the Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR) scale, Global Deterioration Scale (GDS), and Barthel Activities of Daily Living (ADL). Lower urinary tract symptom (LUTS) was assessed using OABSS and voiding diary.Results The prevalence of overactive bladder (OAB) (defined as OABSS ≥3 with an urgency score of ≥2) in patients with AD was 72.6%. Among the OAB subjects, the most common severity of symptom was moderate (72.6%), followed by mild (21.2%), and severe (5.8%). It was found that OABSS had a very high correlation with aging (r=0.75; p<0.001). When compared with neuropsychological parameters, it was found that OABSS was highly correlated with the CDR scores (r=0.446; p<0.001). However, no significant correlation was found between the changes in OABSS scores and those in other neuropsychological parameters. Based on the individual symptom scores, urgency incontinence was highly correlated with the CDR scores (r=0.43; p<0.001).Conclusions OABSS is a useful tool in assessing AD patients with LUTS. There was a consistent positive association between OABSS severity, including urgency incontinence, and CDR scores.

Nursing Home Residents’ Level of Knowledge About Urinary Incontinence

“…In this study, participants with UI generally did not use a coping method (72%) and only 28% were using diapers/ pads. This finding corresponds with those of Jung et al, 35) who reported that only 20% of older Alzheimer's patients used diapers/pads. Göral Türkcü and Kukulu 25) and Demirci et al 24) reported significantly higher percentages of participants in nursing homes using diaper/pads as a coping method for UI (71.6% and 86.4%, respectively).…”

Nocturia in patients with cognitive dysfunction: a systematic review of the literature

“…Four studies specifically enrolled older patients [17,[21][22][23], 3 studies [18][19][20] were conducted in Parkinson's disease (PD) patients and 1 enrolled participants with probable Alzheimer's disease (AD) [11]. Cognitive dysfunction was assessed by Mini-Mental State Examination (MMSE) in 6 studies [11,17,[20][21][22][23], and also the Clinical Dementia Rating (CDR) scale in 1of these studies [11]. The Montreal Cognitive Assessment was used in 1 study [18], and a specific validated scale for impulsivity in PD in 1 study [19].…”

“…The prevalence of cognitive dysfunction ranged from 4 to 58% in the studies which reported this parameter [17,18,23]. Nocturia was defined as self-reported awakening from sleep to pass urine 2 or more times per night [21][22][23], or without any definite threshold [11,17] or by symptom questionnaires [18][19][20]. Overall, nocturia was reported in 19 to 61% of study participants [17,20].…”

“…Notably, there exists a robust association between cognitive dysfunction -which refers to deficits in attention, verbal and nonverbal learning, short-term and working memory, visual and auditory processing, problem solving, processing speed, motor functioning -and other LUTS, particularly urinary incontinence [10][11][12]. Moreover, current literature has identified a diverse array of risk factors common to both nocturia and cognitive dysfunction, including aging, comorbidities [13], brain lesions -particularly those affecting the hypothalamicpituitary axis [14], and sleep disturbances [15].…”

Re: Insufficient conclusions regarding the association between overactive bladder symptoms and degree of dementia

“…Recently, Jung et al ( 1 ) reported a remarkable study on a possible association between the symptoms of overactive bladder (OAB) and the degree of dementia. Considering the paucity of relevant studies on this issue, this study has value.…”