Urinary function in elderly people with and without leukoaraiosis: relation to cognitive and gait function

Area of Science:

• Geriatric Medicine
• Neurology
• Urology

Background:

• White matter lesions (leukoaraiosis) are common in the elderly.
• The relationship between leukoaraiosis and geriatric urinary dysfunction is not fully understood.
• Cognitive and gait impairments are also associated with white matter lesions.

Purpose of the Study:

• To investigate urinary function in elderly individuals with and without white matter lesions.
• To explore the association between white matter lesion severity and urinary, cognitive, and gait function.
• To determine if leukoaraiosis is an early sign of neurological dysfunction in the elderly.

Main Methods:

• Sixty-three elderly subjects (mean age 73) underwent MRI to grade white matter lesions (0-4).
• Urinary function was assessed via questionnaires and urodynamic studies (n=33).
• Cognitive function (MMSE) and gait were also evaluated and compared with urinary findings.

Main Results:

• Subjects with white matter lesions (grade 1-4) showed significantly higher rates of detrusor hyperreflexia (82%) compared to those without (grade 0, 9%).
• Urinary dysfunction, including urge urinary incontinence, was more prevalent in those with grade 1 lesions than cognitive or gait disorders.
• The severity of white matter lesions correlated with increased urinary, cognitive, and gait impairments.

Conclusions:

• Urinary dysfunction is a common finding in elderly individuals with leukoaraiosis.
• Leukoaraiosis is a significant factor associated with geriatric urinary dysfunction.
• Urinary problems may represent an early clinical sign of leukoaraiosis in the elderly population.