Dementia and lower urinary dysfunction: with a reference to anticholinergic use in elderly population

Urinary incontinence is common in patients with dementia, and is more prevalent in demented than in non-demented older individuals. Neurogenic incontinence is common in multiple cerebral infarction and dementia with Lewy bodies, and in both diseases walking difficulty and falls are common. In contrast, functional incontinence is common in Alzheimer's disease due to cognitive disability and decreased motivation. Central cholinergic stimulation is the mainstay in the treatment of cognitive decline. In contrast, to date, the use of anticholinergic medications for detrusor overactivity in the elderly is still under consideration, since anticholinergic drugs may lead to undesirable events particularly in the central nervous system, although many studies have used severely demented cases. In the future, studies seeking treatment regimens for an elderly individual with both dementia and urinary dysfunction are warranted.