Lower Urinary Tract Symptoms Correlation With Motor and Cognitive Function in Patients With Parkinson Disease

Parkinson disease (PD) is a common, progressive neurodegenerative disease, affecting approximately 1% of the population over 60. The associated morbidity and mortality are increasing at a faster rate than for any other neurological disorder. Lower urinary tract symptoms (LUTS) are reported in up to 85% of patients and can significantly impair quality of life (QoL). There are few studies to date that utilise the Montreal Cognitive Assessment (MoCA) to assess cognitive performance and compare this to motor symptoms and LUTS severity.

An observational, cross-sectional study was performed. Data was collected prospectively from patients diagnosed with PD attending a specialist movement disorder clinic using fully validated, detailed questionnaires and scales routinely employed in clinical practice (ICIQ-MLUTS, ICIQ-FLUTS, Unified PD Rating Scale - Motor Examination, modified Hoehn and Yahr, MoCA). Statistical analyses were performed using Stata/MP 17.

Data from 18 patients was collected (15 male and 3 female subjects; median age, 69 years; median disease duration, 4 years; median modified Hoehn and Yahr stage, 2.5; median MoCA score, 24). Urinary incontinence symptoms scores were significantly correlated with worse QoL scores due to LUTS (r=0.76, P<0.001), with total urinary symptoms scores (r=0.82, P<0.001), and negatively correlated with MoCA scores (r=-0.52, P=0.046). No correlation was found between urinary incontinence symptoms and motor symptoms severity scores (r=0.09, P=0.725). The non-drug-naive group (n=12, 66.7%) was found to have higher motor symptoms scores (P=0.065), higher LUTS scores (P=0.239), worse QoL scores due to LUTS (P=0.244), and similar MoCA scores (P=0.785) to the drug-naive group (n=6, 33.3%).

Cognitive impairment in patients with PD appears to be more strongly associated with urinary incontinence severity than motor symptoms. When considering the appropriateness of urological intervention in PD patients, cognitive function should be taken into account as well as motor function.