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Neurourology pp 511-515 | Cite as

Dementia

  • Marcio A. Averbeck
  • Helmut Madersbacher
Chapter

Abstract

Dementia is a pathological, neurodegenerative process leading to progressive decline in cognitive and functional abilities. It has multiple causes, diverse manifestations, and heterogeneity with respect to the impact of sex or gender on prevalence, risk factors, and outcomes. LUTS in dementia patients can be caused by the dementia itself, by the neurological and urological pharmacotherapy, and by the ageing bladder or comorbidities. Overall, urinary incontinence affects around 50% of men and 60% of women with dementia, inevitably occurring in advanced stages of disease. The degree of incontinence is strongly associated with patient’s general status and ambulation. Although LUTS are highly prevalent in dementia patients, high-quality data to guide the choice of treatment strategies in this population are lacking. The extensive and aggressive therapy of LUTS should be reserved for those with good general status and ambulation. Behavioural therapy, including toilet training and prompted voiding, may be especially useful in patients with unawareness UI.

References

  1. 1.
    Podcasy JL, Epperson CN. Considering sex and gender in Alzheimer disease and other dementias. Dialogues Clin Neurosci. 2016;18:437–46.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Panicker J, Sinha S, Taly AB, Mahadevan A, Sagar C, Srikanth SG, et al. Dysmyelinating neuropathy in benign form of megalencephalic leukoencephalopathy with subcortical cysts: a novel observation from south India. Neurol India. 2007;55:399–402.CrossRefGoogle Scholar
  3. 3.
    Sakakibara R, Panicker J, Fowler CJ, Tateno F, Kishi M, Tsuyuzaki Y, et al. Vascular incontinence: incontinence in the elderly due to ischemic white matter changes. Neurol Int. 2012;4:e13.CrossRefGoogle Scholar
  4. 4.
    Sakakibara R, Panicker J, Fowler CJ, Tateno F, Kishi M, Tsuyusaki Y, et al. Is overactive bladder a brain disease? The pathophysiological role of cerebral white matter in the elderly. Int J Urol. 2014;21:33–8.CrossRefGoogle Scholar
  5. 5.
    Schwarzinger M, Thiébaut SP, Baillot S, Mallet V, Rehm J. Alcohol use disorders and associated chronic disease—a national retrospective cohort study from France. BMC Public Health. 2017;18:43.CrossRefGoogle Scholar
  6. 6.
    Ahlberg J, Norlén L, Blomstrand C, Wikkelsö C. Outcome of shunt operation on urinary incontinence in normal pressure hydrocephalus predicted by lumbar puncture. J Neurol Neurosurg Psychiatry. 1988;51:105–8.CrossRefGoogle Scholar
  7. 7.
    Averbeck MA, Altaweel W, Manu-Marin A, Madersbacher H. Management of LUTS in patients with dementia and associated disorders. Neurourol Urodyn. 2017;36:245–52.CrossRefGoogle Scholar
  8. 8.
    Haruta H, Sakakibara R, Ogata T, Panicker J, Fowler CJ, Tateno F, et al. Inhibitory control task is decreased in vascular incontinence patients. Clin Auton Res. 2013;23:85–9.CrossRefGoogle Scholar
  9. 9.
    Kotsoris H, Barclay LL, Kheyfets S, Hulyalkar A, Dougherty J. Urinary and gait disturbances as markers for early multi-infarct dementia. Stroke. 1987;18:138–41.CrossRefGoogle Scholar
  10. 10.
    Mijajlović MD, Pavlović A, Brainin M, Heiss WD, Quinn TJ, Ihle-Hansen HB, et al. Post-stroke dementia—a comprehensive review. BMC Med. 2017;15:11.CrossRefGoogle Scholar
  11. 11.
    Strong K, Mathers C, Bonita R. Preventing stroke: saving lives around the world. Lancet Neurol. 2007;6:182–7.CrossRefGoogle Scholar
  12. 12.
    McKevitt C, Fudge N, Redfern J, Sheldenkar A, Crichton S, Rudd AR, et al. Self-reported long-term needs after stroke. Stroke. 2011;42:1398–403.CrossRefGoogle Scholar
  13. 13.
    Fride Y, Adamit T, Maeir A, Ben Assayag E, Bornstein NM, Korczyn AD, et al. What are the correlates of cognition and participation to return to work after first ever mild stroke? Top Stroke Rehabil. 2015;22:317–25.CrossRefGoogle Scholar
  14. 14.
    Vann Jones SA, O’Brien JT. The prevalence and incidence of dementia with Lewy bodies: a systematic review of population and clinical studies. Psychol Med. 2014;44:673–83.CrossRefGoogle Scholar
  15. 15.
    Onyike CU, Diehl-Schmid J. The epidemiology of frontotemporal dementia. Int Rev Psychiatry. 2013;25:130–7.CrossRefGoogle Scholar
  16. 16.
    Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, et al. Prevalence of dementia and major subtypes in Europe: A collaborative study of population-based cohorts. Neurologic Diseases in the Elderly Research Group. Neurology. 2000;54:S4–9.CrossRefGoogle Scholar
  17. 17.
    de Pedro-Cuesta J, Virués-Ortega J, Vega S, Seijo-Martínez M, Saz P, Rodríguez F, et al. Prevalence of dementia and major dementia subtypes in Spanish populations: a reanalysis of dementia prevalence surveys, 1990–2008. BMC Neurol. 2009;9:55.CrossRefGoogle Scholar
  18. 18.
    Na HR, Park MH, Cho ST, Lee BC, Park S, Kim KH, et al. Urinary incontinence in Alzheimer’s disease is associated with Clinical Dementia Rating-Sum of Boxes and Barthel Activities of Daily Living. Asia Pac Psychiatry. 2015;7:113–20.CrossRefGoogle Scholar
  19. 19.
    Toba K, Ouchi Y, Orimo H, Iimura O, Sasaki H, Nakamura Y, et al. Urinary incontinence in elderly inpatients in Japan: a comparison between general and geriatric hospitals. Aging (Milano). 1996;8:47–54.Google Scholar
  20. 20.
    Campbell AJ, Reinken J, McCosh L. Incontinence in the elderly: prevalence and prognosis. Age Ageing. 1985;14:65–70.CrossRefGoogle Scholar
  21. 21.
    Horimoto Y, Matsumoto M, Akatsu H, Ikari H, Kojima K, Yamamoto T, et al. Autonomic dysfunctions in dementia with Lewy bodies. J Neurol. 2003;250:530–3.CrossRefGoogle Scholar
  22. 22.
    Grant RL, Drennan VM, Rait G, Petersen I, Iliffe S. First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database. PLoS Med. 2013;10:e1001505.CrossRefGoogle Scholar
  23. 23.
    Ransmayr GN, Holliger S, Schletterer K, Heidler H, Deibl M, Poewe W, et al. Lower urinary tract symptoms in dementia with Lewy bodies, Parkinson disease, and Alzheimer disease. Neurology. 2008;70:299–303.CrossRefGoogle Scholar
  24. 24.
    Cacabelos R, Rodríguez B, Carrera C, Caamaño J, Beyer K, Lao JI, et al. APOE-related frequency of cognitive and noncognitive symptoms in dementia. Methods Find Exp Clin Pharmacol. 1996;18:693–706.PubMedGoogle Scholar
  25. 25.
    Hutchinson S, Leger-Krall S, Skodol WH. Toileting: a biobehavioral challenge in Alzheimer’s dementia care. J Gerontol Nurs. 1996;22:18–27.CrossRefGoogle Scholar
  26. 26.
    Tariot PN. Medical management of advanced dementia. J Am Geriatr Soc. 2003;51:S305–13.CrossRefGoogle Scholar
  27. 27.
    Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2000:CD002113.Google Scholar
  28. 28.
    Kay G, Crook T, Rekeda L, Lima R, Ebinger U, Arguinzoniz M, et al. Differential effects of the antimuscarinic agents darifenacin and oxybutynin ER on memory in older subjects. Eur Urol. 2006;50(2):317–26.CrossRefGoogle Scholar
  29. 29.
    Staskin D, Kay G, Tannenbaum C, Goldman HB, Bhashi K, Ling J, et al. Trospium chloride has no effect on memory testing and is assay undetectable in the central nervous system of older patients with overactive bladder. Int J Clin Pract. 2010;64(9):1294–300.CrossRefGoogle Scholar
  30. 30.
    Sakakibara R, Ogata T, Uchiyama T, Kishi M, Ogawa E, Isaka S, et al. How to manage overactive bladder in elderly individuals with dementia? A combined use of donepezil, a central acetylcholinesterase inhibitor, and propiverine, a peripheral muscarine receptor antagonist. J Am Geriatr Soc. 2009;57(8):1515–7.CrossRefGoogle Scholar
  31. 31.
    Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7.CrossRefGoogle Scholar
  32. 32.
    Starr JM. Cholinesterase inhibitor treatment and urinary incontinence in Alzheimer’s disease. J Am Geriatr Soc. 2007;55(5):800–1.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Marcio A. Averbeck
    • 1
  • Helmut Madersbacher
    • 2
  1. 1.Video-Urodynamics Unit, Department of UrologyMoinhos de Vento HospitalPorto AlegreBrazil
  2. 2.Department of UrologyUniversity HospitalInnsbruckAustria

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