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Urinary incontinence in the elderly: the brain factor

D J Griffiths¹, P N McCracken, G M Harrison

¹Department of Applied Sciences in Medicine, University of Alberta, Edmonton, Canada.

Scandinavian Journal of Urology and Nephrology. Supplementum

|January 1, 1994

Summary

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Urge incontinence in the elderly is linked to cognitive issues, especially impaired time orientation. This "brain factor" may explain geriatric urge incontinence, particularly with reduced bladder sensation.

Area of Science:

Geriatric Medicine
Neuroscience
Urology

Background:

Urge incontinence is common in older adults, often co-occurring with reduced bladder sensation.
This condition is frequently associated with cognitive impairment and reduced blood flow to the frontal lobes.

Purpose of the Study:

To investigate the specific cognitive functions associated with urge incontinence in the elderly.
To identify potential
brain factors
contributing to geriatric urge incontinence.

Main Methods:

47 elderly patients with incontinence underwent cognitive testing (CAMCOG), 24-hour bladder monitoring, and videourodynamics.
Cognitive function, bladder sensation, and urine loss were assessed.

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Main Results:

Impaired orientation in time was significantly associated with proven urge incontinence (P < 0.00005).
This temporal disorientation was a stronger predictor than overall cognitive impairment.
Praxis, calculation, abstract thinking, and recent memory showed weaker associations.

Conclusions:

Frontal lobe dysfunction and impaired temporal orientation appear to be key factors in geriatric urge incontinence.
These cognitive deficits, especially when combined with reduced bladder sensation, contribute significantly to the condition.