Management of LUTS in patients with dementia and associated disorders

Averbeck, Márcio Augusto; Altaweel, Waleed; Manu-Marin, A.; Madersbacher, H.

doi:10.1002/nau.22928

Cited by 42 publications

(33 citation statements)

References 68 publications

(165 reference statements)

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“…9 However, patients with vascular dementia manifest various aspects of UI depending on the region of brain damage. 1 UI that is not caused by LUT is characterized by functional incontinence, which occurs when it is not possible to reach the toilet in time due to impaired cognitive activity, or lack of sufficient number of attempts. In patients with dementia, difficulty accessing the toilet, abnormal physical activity, and psychological factors can exacerbate existing UI.…”

Section: Characteristics Of Lutd In Patients With Dementia Uimentioning

confidence: 99%

“…29 When antimuscarinics are prescribed for patients with dementia who are already treated with AChEI, they cross the blood-brain barrier and bind the M1 muscarinic receptors in significant amounts leading to unexpected interactions and rapid deterioration in memory and cognition. 1 Elderly people often consume multiple medications (polypharmacy), so it is necessary to accurately evaluate all medications prior to treatment. 31 Among the medications for chronic diseases, the components of anticholinergic drugs are often contained, so it is important to carefully determine and plan the total amount and duration of treatment with anticholinergic drugs.…”

Section: Antimuscarinicsmentioning

confidence: 99%

“…UI affects the quality of life in patients with dementia, resulting in medical morbidity, impaired self-esteem, early institutionalization in long-term care facilities, stress for families and caregivers, and substantial financial burden. 1 Neurogenic lower urinary tract dysfunction (LUTD) refers to abnormal function of the bladder and urethra in the context of clinically confirmed relevant neurologic disorder. 2 LUTD causes LUTS and is a major subgroup of broad LUTS due to the severity of symptoms and the broader implications of urinary dysfunction for health.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Lower Urinary Tract Dysfunction and Dementia

Cho

2020

Dement Neurocogn Disord

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Lower urinary tract dysfunction (LUTD) is a common health challenge in dementia patients with significant morbidity and socioeconomic burden. It often causes lower urinary tract (LUT) symptoms, restricts activities of daily life, and impairs quality of life. Among several LUT symptoms, urinary incontinence (UI) is the most prominent storage symptom in the later stages of dementia. UI in patients with dementia results not only from cognitive impairment, but also from urological defects such as detrusor overactivity. Management of LUTD in patients with dementia is based on multiple factors, including cognitive state, functional impairment, concurrent comorbidities, polypharmacy and urologic condition. Behavioral therapy under caregiver support represents appropriate treatment strategy for UI in these patients. Pharmacological treatment can be considered in patients refractory to behavioral therapy, but it is more effective when combined with behavioral therapy. Antimuscarinics and mirabegron, a beta-3 receptor agonist, are effective for managing storage symptoms involving the LUT. However, anticholinergic side effects in elderly subjects are a concern, particularly when there is a risk of exacerbating cognitive impairment with prolonged use of antimuscarinics. Proper recognition and treatment of LUTD in dementia can improve quality of life in these patients.

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Section: Characteristics Of Lutd In Patients With Dementia Uimentioning

confidence: 99%

Section: Antimuscarinicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between Lower Urinary Tract Dysfunction and Dementia

Cho

2020

Dement Neurocogn Disord

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“…Moreover, like in our adults with ASD, also in patients with dementia of different origins, storage symptoms are more frequently observed than voiding symptoms. In addition, memory deficits, cognition changes, demyelination, oxidative stress, and inflammation have been reported to be an integral part of both ASD and Alzheimer's disease . Importantly, like in patients with Alzheimer's disease, a β‐amyloid overproduction or excessive deposition causing excessive activation of cortical neurons and neighboring glial cells has been described in patients with ASD .…”

Section: Discussionmentioning

confidence: 99%

Bladder and bowel dysfunction, adaptive behaviour and psychiatric profiles in adults affected by autism spectrum disorders

Gubbiotti

Balboni

Bini

et al. 2019

Neurourology and Urodynamics

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Aims: Bladder and bowel dysfunction (BBD) have been recognized in children affected by autism spectrum disorder (ASD), but no consistent information exist in adults with the condition. We evaluated the prevalence of BBD and the impact of psychiatric and behavioural profiles in adults affected by ASD.Methods: Twenty-two adults and 13 children/teens with ASD and a matched group of typically developing subjects (TD) were prospectively studied. Patients and TD subjects underwent the evaluation of urinary incontinence (UI: diurnal, continuous or intermittent), nocturnal enuresis (NE), and bowel disturbances with the 3-day voiding and bowel diary. In addition, assessment of intellectual disability (ID) and psychiatric and adaptive behaviours with the Neuropsychiatric Inventory Scale (NPI) and the Vineland Adaptive Behaviour Scale 2ndEdition (Vineland-II), was performed. Results: In adults, any type of incontinence was observed in 81.8% of cases, and NE and intermittent UI in 59.0% and 36.3% of patients, respectively. Faecal incontinence and constipation were detected 36.3% and in 68.1% of cases, respectively. ID was severe in 2 cases and profound in 18; NPI and Vineland-II items most affected were "Irritability/Lability," "Motor Activity," and "Agitation," and IQ-Socialization and IQ-Communication. Significant relationships were identified between intermittent UI and greater ID (P < .02) and high "anxiety" (P < .05), and between NE and high "euphoria/elevated mood" (P < .05). These results were similar to those observed in children/teens. Conclusions:Adults with ASD, and greater ID and mood disorders, present with a high prevalence of BBD. A shared pathogenetic mechanism could underlie the co-occurrence of ASD, mood disorders, and BBD. K E Y W O R D Sadaptive behaviour, autism spectrum disorders, bladder and bowel dysfunction

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“…Approaches that may be adopted to deal with the urinary incontinence problem involve the regular of diapers and other absorbent aids, timed voiding, and prompting voiding [55]. Five studies were retained in this section with 149 participants included (see Table 5) [56][57][58][59][60].…”

Section: Introductionmentioning

confidence: 99%

Assistive Technology and Cognitive-Behavioral Programs for Promoting Adaptive Skills of Persons with Alzheimer Disease: A Selective Review

Perilli¹,

Stasolla

Maselli³

et al. 2018

JNRT

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Background: Person with Alzheimer Disease may present cognitive, social, communication, physical, and orientation impairments. Furthermore, individuals with Alzheimer Disease may exhibit challenging behavior, isolation, and passivity. Objectives: To emphasize the role of Assistive Technology-based interventions and Cognitive-Behavioral Programs to improve the independence, and the quality of life of patients with Alzheimer Disease. To assess the effects on teaching adaptive responding, and decreasing challenging behaviors. Method: A selective literature review was carried out considering Alzheimer, Assistive Technology, Cognitive-Behavioral Programs, Adaptive Responding, Challenging Behaviors, and Quality of life as keywords. Twenty-six studies were reviewed. Results: Empirical data demonstrated the effectiveness, and the suitability of the selected interventions, although few failures occurred. The participants involved significantly increased their adaptive responding during the intervention phases, and maintained their performance over the time. Conclusion: Assistive Technology-based rehabilitative programs and Cognitive-Behavioral Interventions may be helpful for promoting the independence and the quality of life of individuals with Alzheimer Disease.

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Management of LUTS in patients with dementia and associated disorders

Cited by 42 publications

References 68 publications

Relationship between Lower Urinary Tract Dysfunction and Dementia

Relationship between Lower Urinary Tract Dysfunction and Dementia

Bladder and bowel dysfunction, adaptive behaviour and psychiatric profiles in adults affected by autism spectrum disorders

Assistive Technology and Cognitive-Behavioral Programs for Promoting Adaptive Skills of Persons with Alzheimer Disease: A Selective Review

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