Association between cognitive impairment and urinary dysfunction in Parkinson’s disease

Tkaczynska, Zuzanna; Padovani, Alessandro; Becker, Sara; Gräber-Sultan, Susanne; Berg, Daniela; Liepelt‐Scarfone, Inga

doi:10.1007/s00702-017-1690-2

Cited by 11 publications

(11 citation statements)

References 42 publications

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“…Bladder dysfunction has been linked to a variety of clinical PD-related symptoms, including cognition (Sakushima et al, 2016;Tkaczynska et al, 2017). On the contrary, a recent study found no association between PD-UU and cognitive impairment (Picillo et al, 2017) where the applied cognitive screening assessment did not provide insight into the domain-specific characterization of cognitive functions.…”

Section: Introductionmentioning

confidence: 99%

Executive Function Is Related to the Urinary Urgency in Non-demented Patients With Parkinson’s Disease

Tkaczynska

Becker

Maetzler

et al. 2020

Front. Aging Neurosci.

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Introduction: Evidence suggests urinary urgency is associated with cognitive impairment in a subtype of Parkinson's disease (PD) patients. This study investigates if cognitive impairment independently predicts the presence of urinary dysfunction. Methods: We report data of 189 idiopathic PD patients, excluding those with concomitant diseases or medication interacting with bladder function. A standardized questionnaire was used to define the presence of urinary urgency. All patients underwent a comprehensive motor, cognitive non-motor and health-related quality of life (HRQoL) assessment. Multivariable linear regression analysis was performed to identify independent variables characterizing urinary urgency in PD (PD-UU), which were assigned as discriminant features to estimate their individual contribution to the phenotype of the PD-UU group. Results: Of 189 PD patients, 115 (60.8%) reported PD-UU. The linear regression analysis showed that among cognitive domains, executive function (EF; p = 0.04) had a significant negative association with PD-UU. In a second model, scores of the Montreal Cognitive Assessment (MoCA) significantly differentiated between study groups (p = 0.007) and also non-motor symptom (NMS) burden (p < 0.001). The third model consisted of reports of HRQoL, of which stigma was the only subscale of the Parkinson's Disease Questionnaire (PDQ-39) differentiating between patients with and without PD-UU (p = 0.02). The linear discriminant analysis provided evidence that the combination of EF, NMS burden, nocturia, and stigma discriminated between groups with 72.4% accuracy. Conclusion: In our large, non-demented PD cohort, urinary urgency was associated with executive dysfunction (EF), supporting a possible causative link between both symptoms. A combination of neuropsychological and non-motor aspects identified patients with PD-UU with high discriminative accuracy.

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Section: Introductionmentioning

confidence: 99%

Executive Function Is Related to the Urinary Urgency in Non-demented Patients With Parkinson’s Disease

Tkaczynska

Becker

Maetzler

et al. 2020

Front. Aging Neurosci.

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“…Several other studies used questionnaires that solely focused on memory, namely the Memory Assessment Clinical Questionnaire (MAC‐Q), The Forgetfulness Assessment Inventory (FAI) and the Cognitive Complaints Interview (CCI). Similarly, a few other studies only asked one question relating to memory.…”

Section: Resultsmentioning

confidence: 99%

“…All of the included studies, except for one, reported cognitive screening tests. Seventeen studies used the Mini Mental State Examination (MMSE) for assessment of global cognitive abilities, while seven studies used Montreal Cognitive Assessment (MoCA), which are the most commonly used screening tests for cognitive decline. The rest of the studies used the Mattis Dementia Rating Scale (MDRS), the Scales for Outcome in PD‐Cognition (SCOPA‐COG), Addenbrooke's Cognitive Examination‐Revised (ACE‐R), the Parkinson Neuropsychometric Dementia Assessment (PANDA) and the Clinical Dementia Rating Scale (CDR).…”

Section: Resultsmentioning

confidence: 99%

“…Although, the term “subjective memory complaints” from the Petersen et al diagnostic criteria for MCI were purposefully substituted with “subjective cognitive complaints” in the new diagnostic criteria for PD‐MCI by Litvan et al, these constructs are still used interchangeably. Of the studies included in this review, five of them still refer to “subjective memory complaints” rather than subjective cognitive complaints. The rest of the studies refer to either “subjective cognitive complaints,” “cognitive complaints,” “subjective cognitive decline” or “problems with cognition.” The distinction between “subjective memory complaints” and “subjective cognitive complaints” is, however, important, and the employment of “memory complaints” rather than “cognitive complaints” may have implications for how these are understood, measured and interpreted.…”

Section: Discussionmentioning

confidence: 99%

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Subjective cognitive complaints in patients with Parkinson's disease

Kjeldsen

Damholdt

2019

Acta Neurol Scand

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Mild cognitive impairment (MCI) is common in Parkinson's disease (PD), affecting almost all patients with PD at some time. It has been shown that patients with PD, who express subjective cognitive complaints, are at a higher risk of eventually developing PD‐MCI. This is corroborated by the Movement Disorders Society's (MDS) diagnostic criteria from 2012 for PD‐MCI, from which it follows that a subjective cognitive complaint must be present in addition to objective cognitive impairment for a patient with PD to receive a diagnosis of PD‐MCI. Nevertheless, there is currently no standardized measurement available for assessing subjective cognitive complaints. Therefore, this review aims to generate an overview of how subjective cognitive complaints are commonly operationalized in the empirical literature as well as whether they are found to be associated with the level of cognitive impairment. The findings revealed that a broad range of measures has been used to obtain subjective cognitive complaints and that there is little consistency between different studies with regard to how they have obtained these complaints, from whom they had obtained them, how many they have obtained, which types of complaints they have obtained and whether they were associated with cognitive impairment. Given the fact that the presence of subjective cognitive complaints is a requirement for setting a diagnosis, there is a need for more methodological consensus with regard to the measurement hereof.

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“…Micturition is a complicated process controlled by the frontal lobe, basal ganglia, brainstem, spinal cord, and the other central autonomic networks [2, 3]. Some studies have found that LUT dysfunction can exacerbate the extent of cognitive dysfunction [4, 5] and might be an early sign of accelerating PD progression [6]. Therefore, discovering the relevant factors and using them to develop an early intervention strategy for LUT dysfunction in PD patients is of great importance.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Lower Urinary Tract Dysfunction and Clinical Features in Chinese Parkinson’s Disease Patients

Han

Wang

et al. 2019

Parkinson's Disease

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Background. Lower urinary tract (LUT) dysfunction is very common in Parkinson’s disease (PD) patients. However, the number of studies conducted on LUT dysfunction and its related factors in Chinese PD patients is very limited, and there is no international consensus concerning the results. Methods. This cross-sectional study enrolled 100 Chinese PD patients. The patients were classified based on their overactive bladder symptom score (OABSS) and then assigned to either a PD with overactive bladder (PD-OAB) group or a PD with no overactive bladder (PD-NOAB) group. A binary logistic regression analysis was performed to identify the accompanying factors for overactive bladder (OAB). Next, correlations between the OABSS and patient sex, age, age of onset, disease duration, MDS-UPDRS-III, H-Y stage, PD subtype, treatment, education, and nonmotor symptoms were analyzed to identify factors correlated with LUT dysfunction. Results. Eighty nine (89%) of the PD patients suffered from LUT dysfunction, and OAB was diagnosed in 45 (45%) of those PD patients. The most common lower urinary tract (LUT) symptom in the PD patients was nighttime frequency (86%), followed by urgency (50%), urge incontinence (34%), and daytime frequency (17%). Patients in the PD-OAB group had an older age and age of onset, were at a more advanced Hoehn–Yahr stage, and had more severe motor symptoms and nonmotor symptoms, including worse cognition, and a greater incidence of REM sleep behavior disorder (RBD). A binary logistic regression analysis showed that a lower Frontal Assessment Battery (FAB) score, higher H-Y stage, and RBD accompanied with a higher prevalence of OAB in PD patients. A multiple linear regression analysis showed that the OABSS was significantly influenced by the FAB score, H-Y stage, RBD, and age. Conclusions. The FAB score, H-Y stage, and RBD are accompanying factors for OAB. A higher OABSS in PD patients was related to a lower FAB score for frontal lobe executive dysfunction, a higher H-Y stage for severity of motor disorders, RBD, and an older age.

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Association between cognitive impairment and urinary dysfunction in Parkinson’s disease

Cited by 11 publications

References 42 publications

Executive Function Is Related to the Urinary Urgency in Non-demented Patients With Parkinson’s Disease

Executive Function Is Related to the Urinary Urgency in Non-demented Patients With Parkinson’s Disease

Subjective cognitive complaints in patients with Parkinson's disease

Relationship between Lower Urinary Tract Dysfunction and Clinical Features in Chinese Parkinson’s Disease Patients

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