Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Institute of Medical Research, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Maturitas. 2024 Sep;187:108042. doi: 10.1016/j.maturitas.2024.108042. Epub 2024 Jun 10.
Overactive bladder (OAB) is a common condition in middle-aged and older women. It has been reported to be potentially linked to cognitive decline, particularly in older adults. This study investigated the association between OAB symptoms and cognitive impairment in middle-aged women.
This cross-sectional study had a sample of 1652 women (mean age 49.3 ± 2.8 years) who were not taking medication for either urinary tract infection or OAB. OAB symptoms and cognitive function were evaluated by self-administered questionnaires: the Overactive Bladder Symptom Score and the Alzheimer's disease 8. Logistic regression models estimated prevalence ratios (PRs) with 95 % confidence intervals (CI) for cognitive impairment according to the presence/absence of OAB. Mediation analyses assessed the impact of poor sleep quality on this association.
Cognitive impairment was more prevalent in women with OAB than in those without OAB (multivariable-adjusted PR: 1.88 [95 % CI: 1.52-2.24]). Women experiencing nocturia (≥twice a night), urinary urgency at least once a week, and urgency urinary incontinence at least once a week had multivariable-adjusted PRs (95 % CI) for cognitive impairment of 2.08 (1.50-2.65), 2.12 (1.66-2.58), and 1.75 (1.17-2.34), respectively. Poor sleep quality mediated 10.81 % [95 % CI: 4.55-19.44 %] of the relationship between OAB and cognitive impairment.
Among middle-aged women not taking OAB medications, OAB symptoms were associated with cognitive impairment, partly because of poor sleep quality. Further research is needed to determine whether early screening of patients with OAB can help identify those susceptible to cognitive impairment associated with OAB medication and if preventive measures should be targeted at this group.
膀胱过度活动症（OAB）是中年和老年女性常见的病症。有报道称，它可能与认知能力下降有关，尤其是在老年人中。本研究旨在调查中年女性中 OAB 症状与认知障碍之间的关联。
这是一项横断面研究，样本为 1652 名女性（平均年龄 49.3±2.8 岁），她们均未服用治疗尿路感染或 OAB 的药物。OAB 症状和认知功能通过自我管理问卷进行评估：膀胱过度活动症症状评分和阿尔茨海默病 8 项。根据是否存在 OAB，逻辑回归模型估计认知障碍的患病率比（PR）及其 95%置信区间（CI）。中介分析评估了睡眠质量差对这种关联的影响。
与没有 OAB 的女性相比，患有 OAB 的女性认知障碍更为常见（多变量调整后的 PR：1.88 [95%CI：1.52-2.24]）。每周至少发生两次夜间多尿、至少每周一次急迫性尿失禁和至少每周一次急迫性尿失禁的女性，认知障碍的多变量调整后 PR（95%CI）分别为 2.08（1.50-2.65）、2.12（1.66-2.58）和 1.75（1.17-2.34）。睡眠质量差部分介导了 OAB 与认知障碍之间的关系（10.81%[95%CI：4.55-19.44%]）。
在未服用 OAB 药物的中年女性中，OAB 症状与认知障碍相关，部分原因是睡眠质量差。需要进一步研究以确定对 OAB 患者进行早期筛查是否有助于识别那些易受与 OAB 药物相关的认知障碍影响的患者，以及是否应针对这一人群采取预防措施。
