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| Review | |||||
| Dementia and Neurocognitive Disorders 2020: 19: 3: 1-9 | |||||
| Relationship between Lower Urinary Tract Dysfunction and Dementia | |||||
|---|---|---|---|---|---|
| Hae Ri Na , 1 Sung Tae Cho 2 | |||||
| 1 Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea 2 Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea | |||||
| Relationship between Lower Urinary Tract Dysfunction and Dementia | |||||
| Hae Ri Na , 1 Sung Tae Cho 2 | |||||
| 1 Department of Neurology, Bobath Memorial Hospital, Seongnam, Korea 2 Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea | |||||
| Lower urinary tract dysfunction (LUTD) is a common health challenge in dementia patients with significant morbidity and socioeconomic burden. It often causes lower urinary tract (LUT) symptoms, restricts activities of daily life, and impairs quality of life. Among several LUT symptoms, urinary incontinence (UI) is the most prominent storage symptom in the later stages of dementia. UI in patients with dementia results not only from cognitive impairment, but also from urological defects such as detrusor overactivity. Management of LUTD in patients with dementia is based on multiple factors, including cognitive state, functional impairment, concurrent comorbidities, polypharmacy and urologic condition. Behavioral therapy under caregiver support represents appropriate treatment strategy for UI in these patients. Pharmacological treatment can be considered in patients refractory to behavioral therapy, but it is more effective when combined with behavioral therapy. Antimuscarinics and mirabegron, a beta-3 receptor agonist, are effective for managing storage symptoms involving the LUT. However, anticholinergic side effects in elderly subjects are a concern, particularly when there is a risk of exacerbating cognitive impairment with prolonged use of antimuscarinics. Proper recognition and treatment of LUTD in dementia can improve quality of life in these patients. |
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| Key Words: Urinary Bladder; Lower Urinary Tract Symptoms; Urinary Incontinence; Dementia; Overactive Urinary Bladder; Underactive Urinary Bladder | |||||
| 대한치매학회지 (Dementia and Neurocognitive Disorders) | |||||
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