Introduction:

Urinary incontinence (UI) is more prevalent in elderly populations with dementia than those without dementia. Alzheimer’s disease (AD) is the most common cause of dementia. Urge UI, the most common type of UI in AD patients, causes more morbidity and mortality. However, it is inconvenient to obtain the report of urodynamic study from AD patient to diagnose urinary incontinence. Nevertheless, it is easier to obtain subjective or objective questionnaires from the patients or the caregivers. The data collected from the questionnaires are used to evaluate if severity of dementia is associated with urge UI and other lower urinary tract symptoms (LUTs).

Patients and Methods:

A total of 43 AD patients were enrolled in this study, all of whom were checked post-void residual (PVR) urine amount by sonography after voiding. The severity of dementia was evaluated by questionnaire including Cognitive Abilities Screening Instrument (CASI), Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), and Clinical Dementia Rating Sub-of-Box (CDR-SB). The LUTs were assessed with International Consultation of Incontinence Questionnaire (ICIQ) and Overactive bladder symptom scores (OABSS) questionnaire. Independent t test and Pearson’s correlation analysis were calculated.

Results:

The average age in both AD with/without urge UI patients is 78 years old. The scores of CDR-SB, OABSS and ICIQ are significantly different in these 2 groups (p = 0.023, p = 0.003, p = 0.001; respectively). However, the neurophysiological scores of CASI, MMSE, CDR, CDR-SB is not correlated with OABSS (r = 0.047, p = 0.382; r = 0.074, p = 0.317; r = 0.087, p = 0.288; r = 0.112, p = 0.237; respectively). Interestingly, if we separate each individual symptom of OAB, there is a significant correlation between CDR-SB and urge UI score (r = 0.314, p = 0.023).

Conclusions:

Higher lower urinary tract symptom scores are noted in AD patients with urge UI. The CDR-SB score is highly correlated with urge UI in AD patients.

中文翻译：

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下尿路症状与阿尔茨海默病严重程度之间的关系

 介绍：

尿失禁（UI）在患有痴呆症的老年人群中比没有痴呆症的老年人群中更常见。阿尔茨海默病（AD）是痴呆症最常见的原因。紧急 UI 是 AD 患者中最常见的 UI 类型，会导致更高的发病率和死亡率。然而，获取AD患者的尿动力学研究报告来诊断尿失禁并不方便。然而，从患者或护理人员那里获得主观或客观问卷更容易。从问卷中收集的数据用于评估痴呆症的严重程度是否与急迫性 UI 和其他下尿路症状 (LUT) 相关。

 患者和方法：

本研究共纳入 43 名 AD 患者，所有患者在排尿后均通过超声检查检查排尿后残余尿量 (PVR)。通过问卷调查评估痴呆的严重程度，包括认知能力筛查仪（CASI）、简易精神状态检查（MMSE）、临床痴呆评分（CDR）和临床痴呆评分子框（CDR-SB）。 LUT 通过国际失禁咨询问卷 (ICIQ) 和膀胱过度活动症症状评分 (OABSS) 问卷进行评估。计算独立t检验和Pearson相关分析。

 结果：

患有/不患有急迫 UI 的 AD 患者的平均年龄均为 78 岁。这两组的 CDR-SB、OABSS 和 ICIQ 评分显着不同（分别为 p = 0.023、p = 0.003、p = 0.001）。然而，CASI、MMSE、CDR、CDR-SB 的神经生理学评分与 OABSS 不相关（r = 0.047，p = 0.382；r = 0.074，p = 0.317；r = 0.087，p = 0.288；r = 0.112，p = 0.237；分别）。有趣的是，如果我们将 OAB 的每个症状分开，CDR-SB 和冲动 UI 评分之间存在显着相关性（r = 0.314，p = 0.023）。

 结论：

患有急迫性 UI 的 AD 患者下尿路症状评分较高。 CDR-SB 评分与 AD 患者的紧急 UI 高度相关。