White Matter Lesions or Alzheimer's Disease: Which Contributes More to Overactive Bladder and Incontinence in Elderly Adults with Dementia?

Takahashi, Osamu; Sakakibara, Ryuji; Panicker, Jalesh N.; Fowler, Clare J.; Tateno, Fuyuki; Kusumoto, Masahiko; Tsuyusaki, Yohei; Yano, Hitoshi; Sugiyama, Megumi; Uchiyama, Tomoyuki; Yamamoto, Tatsuya

doi:10.1111/jgs.12004

Cited by 26 publications

(33 citation statements)

References 7 publications

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“…The prevalence of dementia did not differ significantly between individuals who fell while attempting to toilet at night and other patients who fell. Lower urinary tract function is known to be altered in patients with dementia, with severe nocturia being reported in up to 84% of Lewy body dementia and white matter lesions, respectively . Evidence supports an increased risk of falls even in the early stages of dementia and confirms accompanying changes in gait, balance and fear of falling .…”

Section: Discussionmentioning

confidence: 95%

Toileting‐related falls at night in hospitalised patients: The role of nocturia

et al. 2019

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Objective The purpose of this study was to describe the prevalence and characteristics of toileting‐related falls in hospitalised older people. Methods Retrospective analysis of falls related to night‐time toileting in patients 60 years or over in a tertiary hospital during a one‐year period. Results Overall 34% of falls were related to toileting with at least 44% of these falls occurring during the night. Toilet‐related falls peaked between 11 pm and 1 am, a period that coincides with maximum supine‐induced diuresis. Almost half of night falls occurred at the bedside. In 80% of night toileting‐related falls, patients were mobilising without the recommended level of assistance. Half of all patients had no strategies for toileting documented in their care plan. Conclusion Findings support screening for nocturia in older inpatients and implementation of strategies to reduce both the need for toileting at night and risk factors for falling.

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Section: Discussionmentioning

confidence: 95%

Toileting‐related falls at night in hospitalised patients: The role of nocturia

et al. 2019

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“…Both age‐related WMD (also called vascular dementia) and AD are common causes of elderly dementia, and are known to be independent risks for OAB/urinary incontinence. A recent survey was carried out among 49 mild/moderate dementia patients irrespective of OAB (mean age 76 years), including AD alone in nine, AD + WMD in 15 and WMD alone in 25 . OAB was most common in WMD alone (Fig.…”

Section: Impact Of Wmd Versus Alzheimer's Disease On Oabmentioning

confidence: 99%

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

et al. 2013

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Abbreviations & AcronymsAbstract: Small-vessel disease of the brain affecting the deep white matter characteristically manifests with neurological syndromes, such as vascular dementia and vascular parkinsonism. There is, however, compelling evidence to suggest that white matter disease can cause overactive bladder and incontinence, and in some patients these might be the initial manifestation. As white matter disease increases significantly with age, and preferentially affects the prefrontal deep white matter, white matter disease becomes an anatomical substrate in the brain etiology of overactive bladder. Treatment entails the management of small-vessel disease risk factors and anticholinergic drugs that do not easily penetrate the blood-brain barrier, to improve bladder control. In short, when caring for elderly overactivebladder patients, we should look at both the brain and the bladder.

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“…Both OAB and AD are common, often coexisting in older patients (7). Although AD is known to be an independent risk factor for OAB or urinary incontinence, few studies have been published with regard to research on OAB of elderly patients with AD (3, 8). …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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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.

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White Matter Lesions or Alzheimer's Disease: Which Contributes More to Overactive Bladder and Incontinence in Elderly Adults with Dementia?

Cited by 26 publications

References 7 publications

Toileting‐related falls at night in hospitalised patients: The role of nocturia

Toileting‐related falls at night in hospitalised patients: The role of nocturia

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

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

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