Urinary incontinence in patients with Alzheimer's disease: Relationship between symptom status and urodynamic diagnoses

Abstract

Objective: To assess factors associated with detrusor overactivity in urinary incontinence patients with Alzheimer's disease, and to determine the correlation between the degree of Alzheimer's disease and the presence of detrusor overactivity. Methods: A total of 144 Alzheimer's disease patients (48 men, 96 women; aged 56-97 years) with urinary incontinence were enrolled in this protocol. Cognitive testing was carried out using the Mini-Mental State Examination, the Clinical Dementia Rating scale, the Global Deterioration Scale and Barthel's Activities of Daily Living. Urinary incontinence was assessed using a frequency-volume chart and the Incontinence Questionnaire on Urinary Incontinence Short Form. All study participants had a urodynamic study carried out. Results: Based on the Incontinence Questionnaire on Urinary Incontinence Short Form, the most common type of urinary incontinence was urge urinary incontinence followed by enuresis in men, whereas women most commonly complained of urge urinary incontinence followed by stress urinary incontinence. Detrusor overactivity was found in 57.6% of patients (25 men, 58 women) on urodynamic study. No statistical differences were found between those with and without detrusor overactivity in terms of age, sex or duration of education. No significant correlation was found between changes in Incontinence Questionnaire on Urinary Incontinence Short Form scores and those in the Mini-Mental State Examination, Clinical Dementia Rating and Barthel's Activities of Daily Living status. Multiple logistic regression analysis showed the presence of detrusor overactivity could be predicted using Clinical Dementia Rating and Barthel's Activities of Daily Living scores (P < 0.05). Conclusions: The most common type of urinary incontinence in patients with Alzheimer's disease is urge urinary incontinence. Clinical Dementia Rating and Barthel's Activities of Daily Living predict the severity of detrusor overactivity in this patient population.