Is overactive bladder a brain disease? The pathophysiological role of cerebral white matter in the elderly

Sakakibara, Ryuji; Panicker, Jalesh N.; Fowler, Clare J.; Tateno, Fuyuki; Kusumoto, Masahiko; Tsuyusaki, Yohei; Yamanishi, Tomonori; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yano, Masashi

doi:10.1111/iju.12288

Cited by 67 publications

(60 citation statements)

References 88 publications

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“…Accumulated oxidative stress and pro-inflammatory status may also influence the decline in bladder function [28, 29]. Moreover, with aging, an increase in small vessel disease in the frontal cortex, which functions as a micturition center, can cause OAB [30]. …”

Section: Discussionmentioning

confidence: 99%

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Analysis of the prevalence and associated factors of overactive bladder in adult Korean men

2017

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Overactive bladder (OAB) is a prevalent condition characterized by lower urinary tract symptoms (LUTS). Age, education, income, marital status, sleep, and emotional problems have been associated with OAB; however, conflicting results exist. The present study was conducted to estimate the prevalence of OAB and comprehensively analyze its associated factors in a large cross-sectional, population-based study. The data of 94,554 participants aged 19–107 were analyzed from the Korean Community Health Survey (KCHS) of 2012. Data on marital status, physical activity, education level, occupation, body mass index (BMI), income level, sleep time, and stress level were retrieved for all enrolled participants. The overactive bladder symptom score (OABSS) was used to evaluate the presence and degree of OAB. Simple and multiple logistic regression analyses with complex sampling were used for the associations between various factors and the presence of OAB. Overall, OAB was present in approximately 2.9% of the participants. The prevalence of OAB increased with age and steeply increased after 60 years of age (adjusted odds ratio [AOR] for each 10 years = 1.70, 95% confidence interval [CI] = 1.61–1.80, P<0.001). The prevalence of OAB was lower in married than unmarried subjects (AOR = 0.59, 95% CI = 0.48–0.72, P<0.001). The prevalence of OAB was significantly different according to occupation Compared to manager, expert, specialist, clerk group, the prevalence of OAB was highest in unemployed group (AOR = 1.90, 95% CI = 1.55–2.32, P < 0.001). Being underweight was correlated with OAB (AOR = 1.29, 95% CI = 1.08–1.55, P = 0.018). Inadequate sleep showed a significant association with OAB (AOR = 1.13, 95% CI = 1.02–1.25 for ≤6 hours of sleep time and AOR = 1.53, 95% CI = 1.27–1.86 for ≥9 hours of sleep, P<0.001). Stress level showed a dose-dependent positive association with OAB [AOR (95% CI) = 3.91 (3.13–4.89) > 2.16 (1.88–2.48) > 1.39 (1.23–1.57) for severe stress > moderate stress > some stress, respectively, P<0.001]. A medical history of diabetes mellitus, hyperlipidemia, and/or cerebral stroke was significantly related to OAB. Approximately 2.9% of adult Korean men experienced OAB based on the OABSS. Unmarried status; occupation; being underweight; inadequate sleep; stress; and medical history of diabetes mellitus, hyperlipidemia, or cerebral stroke were significantly correlated with OAB.

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Section: Discussionmentioning

confidence: 99%

“…Diabetes was especially related to bladder dysfunction, which occurs in 80% of diabetic patients [29]. These associations were suggested to depend on the deregulation of the autonomic nervous system and subsequent bladder dysfunction in compromised diabetes patients [12, 30]. …”

Section: Discussionmentioning

confidence: 99%

Analysis of the prevalence and associated factors of overactive bladder in adult Korean men

2017

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“…All white matter disease demonstrates diffuse abnormalities in the small deep perforating vessels of the hemispheric white matter, basal ganglia, and brain stem and can be associated with atherosclerotic risk factors such as dyslipidemia, diabetes, obesity, metabolic syndrome, hypertension, and smoking. 14 …”

Section: Neurologicmentioning

confidence: 99%

The Aging Overactive Bladder: a Review of Aging-Related Changes from the Brain to the Bladder

Suskind

2017

Curr Bladder Dysfunct Rep

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Purpose of review To understand the current literature on age-related neural and detrusor changes associated with overactive bladder symptoms. Recent findings Recent functional magnetic resonance imaging (fMRI) studies have unveiled an age-related decrease in the neural control of continence, represented in the insula, anterior cingulate cortex (ACC) and prefrontal cortex (PFC). Older individuals with overactive bladder symptoms also demonstrate heightened activation of the ACC with low volumes, representing increased bladder sensitivity or sense of urgency. At the level of the bladder, age-related changes in the urothelium, neurotransmitters/receptors (both muscarinic and purinergic), and inflammation [including nerve growth factor (NGF), monocyte chemoattractant protein-1 (MCP-1) and oxidative stress] are also associated with overactive bladder. Summary Overactive bladder among older adults is a complex condition incorporating physiologic age-related changes from the brain to the bladder and beyond.

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“…OAB can result from dysfunction of cortical control centers, loss of inhibitory mechanisms within the detrusor muscle, or other dysfunctions of the neuromuscular system. 63–65 A correlation between inflammation and both OAB and interstitial cystitis (IC)/painful bladder syndrome (PBS) has been reported. 66,67 Biomarker studies may help explain mechanistic etiologies, thereby resulting in novel targets for therapeutic development, or serve to identify etiology-specific subgroups of symptom-based diagnoses to enable investigation of them as separate entities.…”

Section: Biological Basis Of Urologic Diseases In Womenmentioning

confidence: 99%

Expert Panel Recommendations on Lower Urinary Tract Health of Women Across Their Life Span

Losada¹,

Amundsen

Ashton‐Miller

et al. 2016

Journal of Women's Health

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Urologic and kidney problems are common in women across their life span and affect their daily life, including physical activity, sexual relations, social life, and future health. Urological health in women is still understudied and the underlying mechanisms of female urological dysfunctions are not fully understood. The Society for Women's Health Research (SWHR®) recognized the need to have a roundtable discussion where researchers and clinicians would define the current state of knowledge, gaps, and recommendations for future research directions to transform women's urological health. This report summarizes the discussions, which focused on epidemiology, clinical presentation, basic science, prevention strategies, and efficacy of current therapies. Experts around the table agreed on a set of research, education, and policy recommendations that have the potential to dramatically increase awareness and improve women's urological health at all stages of life.

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Is overactive bladder a brain disease? The pathophysiological role of cerebral white matter in the elderly

Cited by 67 publications

References 88 publications

Analysis of the prevalence and associated factors of overactive bladder in adult Korean men

Analysis of the prevalence and associated factors of overactive bladder in adult Korean men

The Aging Overactive Bladder: a Review of Aging-Related Changes from the Brain to the Bladder

Expert Panel Recommendations on Lower Urinary Tract Health of Women Across Their Life Span

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