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Subtypes of overactive bladder in old age

G Geirsson1, M Fall, S Lindström

  • 1Department of Surgery, Sahlgrenska University Hospital, Sweden.

Age and Ageing
|March 1, 1993
PubMed
Summary

Urinary incontinence and overactive bladder increase with age. In elderly patients, a specific subtype, uninhibited overactive bladder, significantly rises, indicating suprapontine dysfunction.

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Area of Science:

  • Gerontology
  • Urology
  • Neuroscience

Background:

  • Urinary incontinence prevalence rises with age, primarily linked to urge incontinence and bladder overactivity.
  • Bladder overactivity is hypothesized to stem from disrupted central neuronal control of the lower urinary tract.
  • Neurogenic lesions or dysfunctions are expected to manifest distinct functional and urodynamic characteristics.

Purpose of the Study:

  • To investigate the distribution of three recently identified urodynamic subtypes of bladder overactivity in elderly patients.
  • To analyze the age-related prevalence of overactive bladder and its subtypes.

Main Methods:

  • Retrospective study of 814 patients aged 65 years or older with urgency and/or urge incontinence symptoms.
  • Cystometry and ice-water testing were performed on all participants.
  • Analysis of urodynamic subtypes and their prevalence in the elderly cohort.

Main Results:

  • Overactive bladder was present in 33% (267/814) of elderly patients, with prevalence remaining constant until age 65.
  • A significant increase in overactive bladder prevalence was observed above age 65.
  • The 'uninhibited overactive bladder' subtype, indicative of suprapontine dysfunction, accounted for 70% of overactive bladders in older patients.

Conclusions:

  • The marked increase in overactive bladder in the elderly is primarily driven by the 'uninhibited overactive bladder' subtype.
  • This subtype is characterized by coordinated reflex micturition, abnormal bladder fullness perception, and lack of voluntary inhibitory control.
  • Findings suggest suprapontine dysfunction as a key factor in age-related overactive bladder.

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