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Updated: Jul 3, 2026
06:39
Real-Time Void Spot Assay
Published on: February 10, 2023
Dementia and lower urinary dysfunction: with a reference to anticholinergic use in elderly population.
Ryuji Sakakibara1, Tomoyuki Uchiyama, Tomonori Yamanishi
1Department of Internal Medicine, Neurology Division, Sakura Medical Center, Toho University, Sakura, Chiba, Japan. sakakibara@sakura.med.toho-u.ac.jp
Summary
Urinary incontinence is common in dementia patients, with different types linked to specific conditions like Alzheimer's disease. Treatment requires careful consideration, especially regarding medications affecting the central nervous system.
Area of Science:
- Geriatrics
- Neurology
- Urology
Background:
- Urinary incontinence (UI) is highly prevalent in older individuals with dementia.
- Different dementia types present distinct UI patterns: neurogenic UI in dementia with Lewy bodies and multiple cerebral infarction, and functional UI in Alzheimer's disease.
Purpose of the Study:
- To explore the relationship between dementia subtypes and urinary incontinence.
- To discuss current and potential therapeutic strategies for managing UI in elderly dementia patients.
Main Methods:
- Review of existing literature on dementia and urinary incontinence.
- Analysis of UI prevalence and types across different dementia pathologies.
- Discussion of pharmacological treatments, focusing on cholinergic and anticholinergic agents.
Main Results:
- Neurogenic UI is common in dementia with Lewy bodies and multiple cerebral infarction, often co-occurring with gait disturbances and falls.
- Functional UI is prevalent in Alzheimer's disease, linked to cognitive impairment and reduced motivation.
- Central cholinergic stimulation is standard for cognitive decline, while anticholinergic use for detrusor overactivity in the elderly requires caution due to potential CNS side effects.
Conclusions:
- Urinary incontinence is a significant comorbidity in dementia patients, varying by dementia type.
- Anticholinergic medication use in elderly patients with dementia and urinary dysfunction needs careful evaluation due to risks.
- Further research is essential to develop effective, safe treatment regimens for comorbid dementia and urinary dysfunction in the elderly.
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The progression of dementia is generally gradual.
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