下尿路症状与阿尔茨海默病严重程度的关系。
The Relationship Between Lower Urinary Tract Symptoms and Severity of Alzheimer's Disease.
机构信息
Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung.
Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung.
出版信息
Am J Alzheimers Dis Other Demen. 2021 Jan-Dec;36:1533317521992657. doi: 10.1177/1533317521992657.
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.
介绍
在患有痴呆症的老年人群中，尿失禁（UI）比没有痴呆症的人群更为普遍。阿尔茨海默病（AD）是痴呆症最常见的病因。在 AD 患者中，急迫性尿失禁是最常见的尿失禁类型，会导致更多的发病率和死亡率。然而，从 AD 患者那里获得尿动力学研究报告来诊断尿失禁并不方便。尽管如此，从患者或护理人员那里获得主观或客观的问卷要容易得多。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尿失禁和其他下尿路症状（LUTs）相关。
患者和方法
本研究共纳入 43 例 AD 患者，所有患者在排尿后均通过超声检查残余尿量。通过认知能力筛查工具（CASI）、简易精神状态检查（MMSE）、临床痴呆评定量表（CDR）和临床痴呆评定子量表（CDR-SB）问卷评估痴呆症的严重程度。通过国际尿失禁咨询问卷（ICIQ）和逼尿过度症状评分（OABSS）问卷评估 LUTs。计算独立样本 t 检验和 Pearson 相关分析。
结果
伴有/不伴有急迫性尿失禁的 AD 患者的平均年龄均为 78 岁。在这两组患者中，CDR-SB、OABSS 和 ICIQ 评分存在显著差异（p = 0.023，p = 0.003，p = 0.001；分别）。然而，CASI、MMSE、CDR 和 CDR-SB 的神经生理学评分与 OABSS 无相关性（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 的每个单独症状分开，CDR-SB 与急迫性尿失禁评分之间存在显著相关性（r = 0.314，p = 0.023）。
结论
AD 伴有急迫性尿失禁的患者的下尿路症状评分较高。AD 患者的 CDR-SB 评分与急迫性尿失禁高度相关。
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