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Urinary Incontinence in People Living with Cognitive Impairment

  • Geriatric Urology (H Richter and C Parker-Autry, Section Editors)
  • Published:
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Abstract

Purpose of Review

Urinary incontinence is common in adults with cognitive impairment due to a dementia. There are few data which systematically assess the factors underlying incontinence in this medically complex and vulnerable group and a paucity of evidence by which to guide treatment. This review covers what is known and suggests how to adjust the assessment and management of incontinence in an older adult living with dementia.

Recent Findings

A dementia diagnosis is not a bar to receiving either adequate assessment or management of incontinence. Pelvic floor muscle therapy is an effective conservative intervention. Conservative interventions combining gait stability and stamina with pelvic floor muscle therapy and prompted voiding are effective but rely on care partner participation.

Summary

There are a variety of non-pharmacological management strategies that can be employed for persons living with dementia, depending on the individual’s cognitive status and care partner availability.

Caution should be used with antimuscarinic therapy in treating overactive bladder and urgency incontinence. However, in many cases, the benefits of antimuscarinic therapy far outweigh the risks.

Individualizing management according to the patient’s personal wishes, the degree of available caregiver support and the level of cognitive functioning is paramount to ensure treatment goals and expectations are met.

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References

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  1. D'Ancona C, Haylen B, Oelke M, Abranches-Monteiro L, Arnold E, Goldman H, et al. The international continence society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction. Neurourol Urodyn. 2019;38(2):433–77.

    Article  PubMed  Google Scholar 

  2. Jerez-Roig J, Santos MM, Souza DLB, Amaral FLJS, Lima KC. Prevalence of urinary incontinence and associated factors in nursing home residents. Neurourol Urodyn. 2016;35(1):102–7.

    Article  PubMed  Google Scholar 

  3. Santos ICRV, dos Santos Júnior JL, da Silva TFL, Albuquerque NMS, da Silva Filho JC, Valença MP. Urinary incontinence in resident women in nursing homes. Int J Urol Nurs. 2019;13(3):99–105.

    Article  Google Scholar 

  4. Lim YM, Lee SR, Choi EJ, Jeong K, Chung HW. Urinary incontinence is strongly associated with depression in middle-aged and older Korean women: data from the Korean longitudinal study of ageing. Eur J Obstet Gynecol Reprod Biol. 2018;220:69–73.

    Article  PubMed  Google Scholar 

  5. Vrijens D, Drossaerts J, van Koeveringe G, van Kerrebroeck P, van Os J, Leue C. Affective symptoms and the overactive bladder - a systematic review. J Psychosom Res. 2015;78(2):95–108.

    Article  PubMed  Google Scholar 

  6. Choi EP, Lam CL, Chin WY. The health-related quality of life of Chinese patients with lower urinary tract symptoms in primary care. Qual Life Res. 2014;23(10):2723–33.

    Article  PubMed  Google Scholar 

  7. Felde G, Ebbesen MH, Hunskaar S. Anxiety and depression associated with urinary incontinence. A 10-year follow-up study from the Norwegian HUNT study (EPINCONT). Neurourol Urodyn. 2017;36(2):322–8.

    Article  PubMed  Google Scholar 

  8. Lai HH, Shen B, Rawal A, Vetter J. The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population. BMC Urol. 2016;16(1):60.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Choi EP, Lam CL, Chin WY. Mental health of Chinese primary care patients with lower urinary tract symptoms. Psychol Health Med. 2016;21(1):113–27.

    Article  PubMed  Google Scholar 

  10. Lai HH, Rawal A, Shen B, Vetter J. The relationship between anxiety and overactive bladder or urinary incontinence symptoms in the Clinical population. Urology. 2016;98:50–7.

    Article  PubMed  Google Scholar 

  11. Radoja, I. and D. Degmecic, Quality of Life and Female Sexual Dysfunction in Croatian Women with Stress-, Urgency- and Mixed Urinary Incontinence: Results of a Cross-Sectional Study. Medicina (Kaunas), 2019. 55(6).

  12. Gray T, Li W, Campbell P, Jha S, Radley S. Evaluation of coital incontinence by electronic questionnaire: prevalence, associations and outcomes in women attending a urogynaecology clinic. Int Urogynecol J. 2018;29(7):969–78.

    Article  PubMed  Google Scholar 

  13. Singh DKA, Shahar S, Vanoh D, Kamaruzzaman SB, Tan MP. Diabetes, arthritis, urinary incontinence, poor self-rated health, higher body mass index and lower handgrip strength are associated with falls among community-dwelling middle-aged and older adults: pooled analyses from two cross-sectional Malaysian datasets. Geriatr Gerontol Int. 2019;19(8):798–803.

    Article  PubMed  Google Scholar 

  14. Hwang TY, Kim SK, Kim KH, Kim JY. Association between lower urinary tract symptoms and falls in adults males: based on the Korean community health survey. Asia Pac J Public Health. 2019;31(7):643–51.

    Article  PubMed  Google Scholar 

  15. Noguchi N, Chan L, Cumming RG, Blyth FM, Naganathan V. A systematic review of the association between lower urinary tract symptoms and falls, injuries, and fractures in community-dwelling older men. Aging Male. 2016;19(3):168–74.

    Article  PubMed  Google Scholar 

  16. Schluter PJ, Arnold EP, Jamieson HA. Falls and hip fractures associated with urinary incontinence among older men and women with complex needs: a national population study. Neurourol Urodyn. 2018;37(4):1336–43.

    Article  PubMed  Google Scholar 

  17. Szabo SM, Gooch KL, Walker DR, Johnston KM, Wagg AS. The association between overactive bladder and falls and fractures: a systematic review. Adv Ther. 2018;35(11):1831–41.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gotoh M, Matsukawa Y, Yoshikawa Y, Funahashi Y, Kato M, Hattori R. Impact of urinary incontinence on the psychological burden of family caregivers. Neurourol Urodyn. 2009;28(6):492–6.

    Article  PubMed  Google Scholar 

  19. Tamanini JT, et al. Association between urinary incontinence in elderly patients and caregiver burden in the city of Sao Paulo/Brazil: health, wellbeing, and ageing study. Neurourol Urodyn. 2011;30(7):1281–5.

    Article  PubMed  Google Scholar 

  20. Schussler S, Dassen T, Lohrmann C. Care dependency and nursing care problems in nursing home residents with and without dementia: a cross-sectional study. Aging Clin Exp Res. 2016;28(5):973–82.

    Article  PubMed  Google Scholar 

  21. • Hagglund, D., A systematic literature review of incontinence care for persons with dementia: the research evidence. J Clin Nurs, 2010. 19(3-4): p. 303-12. The most recent systematic review of the evidence in conservative therapies, in this group.

  22. The management of lower urinary tract symptoms in men, in Clinical guideline 97. 2010, National Clinical Guideline Centre: London, UK.

  23. In Urinary Incontinence in Women: The Management of Urinary Incontinence in Women. 2013: London.

  24. Lucas MG, Bosch RJ, Burkhard FC, Cruz F, Madden TB, Nambiar AK, et al. European Association of Urology guidelines on assessment and nonsurgical management of urinary incontinence. Actas urologicas espanolas. 2013;37(4):199–213.

    CAS  PubMed  Google Scholar 

  25. Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366(9503):2112–7.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2013;9(1):63–75 e2.

    Article  Google Scholar 

  27. Prince M, Ali GC, Guerchet M, Prina AM, Albanese E, Wu YT. Recent global trends in the prevalence and incidence of dementia, and survival with dementia. Alzheimers Res Ther. 2016;8(1):23.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ouslander JG, Uman GC, Urman HN, Rubenstein LZ. Incontinence among nursing home patients: clinical and functional correlates. J Am Geriatr Soc. 1987;35(4):324–30.

    Article  CAS  PubMed  Google Scholar 

  29. Østbye, T., Borrie, M.J., Hunskaar, S., The prevalence of urinary incontinence in elderly Canadians and its association with dementia, ambulatory function, and institutionalization. Norsk epidemiologi., 2009. 8(2).

  30. Huang AJ, Brown JS, Thom DH, Fink HA, Yaffe K, Study of Osteoporotic Fractures Research Group. Urinary incontinence in older community-dwelling women: the role of cognitive and physical function decline. Obstet Gynecol. 2007;109(4):909–16.

    Article  PubMed  Google Scholar 

  31. Ostbye T, et al. A 10-year follow-up of urinary and fecal incontinence among the oldest old in the community: the Canadian study of health and aging. Can J Aging. 2004;23(4):319–31.

    Article  PubMed  Google Scholar 

  32. Thom DH, Haan MN, Van Den Eeden SK. Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality. Age Ageing. 1997;26(5):367–74.

    Article  CAS  PubMed  Google Scholar 

  33. Alcorn G, Law E, Connelly PJ, Starr JM. Urinary incontinence in people with Alzheimer's disease. International journal of geriatric psychiatry. 2014;29(1):107–9.

    Article  PubMed  Google Scholar 

  34. Resnick NM, Yalla SV, Laurino E. The pathophysiology of urinary incontinence among institutionalized elderly persons. N Engl J Med. 1989;320(1):1–7.

    Article  CAS  PubMed  Google Scholar 

  35. Lee SH, Cho ST, Na HR, Ko SB, Park MH. Urinary incontinence in patients with Alzheimer's disease: relationship between symptom status and urodynamic diagnoses. International journal of urology : official journal of the Japanese Urological Association. 2014;21(7):683–7.

    Article  Google Scholar 

  36. Sugimoto T, Yoshida M, Ono R, Murata S, Saji N, Niida S, et al. Frontal lobe function correlates with one-year incidence of urinary incontinence in elderly with Alzheimer disease. J Alzheimers Dis. 2017;56(2):567–74.

    Article  CAS  PubMed  Google Scholar 

  37. Ogama N, Yoshida M, Nakai T, Niida S, Toba K, Sakurai T. Frontal white matter hyperintensity predicts lower urinary tract dysfunction in older adults with amnestic mild cognitive impairment and Alzheimer's disease. Geriatr Gerontol Int. 2016;16(2):167–74.

    Article  PubMed  Google Scholar 

  38. Kunkle CM, Abernethy MG, van Tongeren LR, Fashokun TB, Wright EJ, Chen CCG. Prevalence of cognitive impairment in older women with pelvic floor disorders. Int Urogynecol J. 2017;28(11):1645–50.

    Article  PubMed  Google Scholar 

  39. Association;, A.s. Alzheimer’s Disease Facts and Figures. Alzheimers Dement. 2019;15:321–87.

    Google Scholar 

  40. Cassells C, Watt E. The impact of incontinence on older spousal caregivers. J Adv Nurs. 2003;42(6):607–16.

    Article  PubMed  Google Scholar 

  41. Drennan VM, Cole L, Iliffe S. A taboo within a stigma? A qualitative study of managing incontinence with people with dementia living at home. BMC Geriatr. 2011;11:75.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Stewart TV, Loskutova N, Galliher JM, Warshaw GA, Coombs LJ, Staton EW, et al. Practice patterns, beliefs, and perceived barriers to care regarding dementia: a report from the American Academy of family physicians (AAFP) national research network. J Am Board Family Med: JABFM. 2014;27(2):275–83.

    Article  Google Scholar 

  43. Fox C, Richardson K, Maidment ID, Savva GM, Matthews FE, Smithard D, et al. Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. J Am Geriatr Soc. 2011;59(8):1477–83.

    Article  PubMed  Google Scholar 

  44. Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Fox C, Livingston G, Maidment ID, Coulton S, Smithard DG, Boustani M, et al. The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. Age Ageing. 2011;40(6):730–5.

    Article  PubMed  Google Scholar 

  46. Furlanetto K, Emond K. "will I come home incontinent?" a retrospective file review: incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over. Collegian. 2016;23(1):79–86.

    Article  PubMed  Google Scholar 

  47. Xu D, Kane RL. Effect of urinary incontinence on older nursing home residents' self-reported quality of life. J Am Geriatr Soc. 2013;61(9):1473–81.

    Article  PubMed  Google Scholar 

  48. Rose A, Thimme A, Halfar C, Nehen HG, Rübben H. Severity of urinary incontinence of nursing home residents correlates with malnutrition, dementia and loss of mobility. Urol Int. 2013;91(2):165–9.

    Article  PubMed  Google Scholar 

  49. Higami Y, Yamakawa M, Kang Y, Kobayashi S, Liao XY, Sung HC, et al. Prevalence of incontinence among cognitively impaired older residents in long-term care facilities in East Asia: a cross-sectional study. Geriatr Gerontol Int. 2019;19(5):444–50.

    Article  PubMed  Google Scholar 

  50. Schussler, S., T. Dassen, and C. Lohrmann, Care dependency and nursing care problems in nursing home residents with and without dementia: a cross-sectional study. Aging Clin Exp Res, 2014.

  51. Nambiar AK, Bosch R, Cruz F, Lemack GE, Thiruchelvam N, Tubaro A, et al. EAU guidelines on assessment and nonsurgical Management of Urinary Incontinence. Eur Urol. 2018;73(4):596–609.

    Article  PubMed  Google Scholar 

  52. Lightner DJ, Gomelsky A, Souter L, Vasavada SP. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment 2019. J Urol. 2019;202(3):558–63.

    Article  PubMed  Google Scholar 

  53. Wagg A, Gibson W, Ostaszkiewicz J, Johnson T III, Markland A, Palmer MH, et al. Urinary incontinence in frail elderly persons: report from the 5th international consultation on incontinence. Neurourol Urodyn. 2015;34(5):398–406.

    Article  PubMed  Google Scholar 

  54. Averbeck MA, Altaweel W, Manu-Marin A, Madersbacher H. Management of LUTS in patients with dementia and associated disorders. Neurourol Urodyn. 2017;36(2):245–52.

    Article  PubMed  Google Scholar 

  55. Ha E, Kim K. Factors that influence activities of daily living in the elderly with probable dementia. J Psychiatr Ment Health Nurs. 2014;21(5):447–54.

    Article  CAS  PubMed  Google Scholar 

  56. •• Gibson, W., et al., Incontinence in frail elderly persons: report of the 6th international consultation on incontinence. Neurourol Urodyn, 2021;40(1):38–54. The latest evidence synthesis from the Intenational Consultation covering frail older adults including those living with dementia.

  57. Lai CKY, Wan X. Using prompted voiding to manage urinary incontinence in nursing homes: can it be sustained? J Am Med Dir Assoc. 2017;18(6):509–14.

    Article  PubMed  Google Scholar 

  58. Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2000;2:CD002113.

    Google Scholar 

  59. Ouslander JG, Schnelle JF, Uman G, Fingold S, Nigam JG, Tuico E, et al. Predictors of successful prompted voiding among incontinent nursing home residents. JAMA. 1995;273(17):1366–70.

    Article  CAS  PubMed  Google Scholar 

  60. Engberg S, et al. Effectiveness of prompted voiding in treating urinary incontinence in cognitively impaired homebound older adults. J Wound Ostomy Continence Nurs. 2002;29(5):252–65.

    PubMed  Google Scholar 

  61. de Codt A, Grotz C, Degaute MF, Tecco JM, Adam S. Management of Demented Patients with urinary incontinence: a case study. Clin Neuropsychol. 2015;29(5):707–22.

    Article  PubMed  Google Scholar 

  62. Ostaszkiewicz J, Roe B, Johnston L. Effects of timed voiding for the management of urinary incontinence in adults: systematic review. J Adv Nurs. 2005;52(4):420–31.

    Article  PubMed  Google Scholar 

  63. Lancioni GE, Singh NN, O’Reilly MF, Sigafoos J, Bosco A, Zonno N, et al. Persons with mild or moderate Alzheimer's disease learn to use urine alarms and prompts to avoid large urinary accidents. Res Dev Disabil. 2011;32(5):1998–2004.

    Article  PubMed  Google Scholar 

  64. Sherburn M, Bird M, Carey M, Bø K, Galea MP. Incontinence improves in older women after intensive pelvic floor muscle training: an assessor-blinded randomized controlled trial. Neurourol Urodyn. 2011;30(3):317–24.

    Article  PubMed  Google Scholar 

  65. Engberg S, Sereika SM. Effectiveness of pelvic floor muscle training for urinary incontinence: comparison within and between nonhomebound and homebound older adults. J Wound Ostomy Continence Nurs. 2016;43(3):291–300.

    Article  PubMed  Google Scholar 

  66. Lee BA, Kim SJ, Choi DK, Kwon O, Na HR, Cho ST. Effects of pelvic floor muscle exercise on urinary incontinence in elderly women with cognitive impairment. Int Neurourol J. 2017;21(4):295–301.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Sherburn M, Bird M, Carey M, Bø K, Galea MP. Incontinence improves in older women after intensive pelvic floor muscle training: an assessor-blinded randomized controlled trial. Neurourol Urodyn. 2011;30(3):317–24.

    Article  PubMed  Google Scholar 

  68. Fantl JA, Wyman JF, McClish D, Harkins SW, Elswick RK, Taylor JR, et al. Efficacy of bladder training in older women with urinary incontinence. JAMA. 1991;265(5):609–13.

    Article  CAS  PubMed  Google Scholar 

  69. Ouslander JG, Griffiths PC, McConnell E, Riolo L, Kutner M, Schnelle J. Functional incidental training: a randomized, controlled, crossover trial in veterans affairs nursing homes. J Am Geriatr Soc. 2005;53(7):1091–100.

    Article  PubMed  Google Scholar 

  70. Wagg, A., Khullar, V., Marscall-Kehrel, D., Michel, M., Oelke, M., Tincello, D., Darekar, A., Ebel Bitoun, C., Osterloh, I., Weinstein D., Assessment of fesoterodine treatment in older people with overactive bladder: Results of SOFIA, a double blind, placebo controlled pan -European trial. Proceedings of the meeting of the Euopean Urology Association, 2010: p. 880.

  71. Wagg A, Staskin D, Engel E, Herschorn S, Kristy RM, Schermer CR. Efficacy, safety, and tolerability of mirabegron in patients aged >/=65yr with overactive bladder wet: a phase IV, double-blind, randomised, placebo-controlled study (PILLAR). Eur Urol. 2020;77(2):211–20.

    Article  CAS  PubMed  Google Scholar 

  72. Dubeau, C.E., et al., Effect of Fesoterodine in vulnerable elderly subjects with urgency incontinence: a double-blind. Placebo Controlled Trial. The Journal of urology, 2013.

  73. Sink KM, Thomas J III, Xu H, Craig B, Kritchevsky S, Sands LP. Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes. J Am Geriatr Soc. 2008;56(5):847–53.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Lackner TE, Wyman JF, McCarthy TC, Monigold M, Davey C. Efficacy of oral extended-release oxybutynin in cognitively impaired older nursing home residents with urge urinary incontinence: a randomized placebo-controlled trial. J Am Med Dir Assoc. 2011;12(9):639–47.

    Article  PubMed  Google Scholar 

  75. Ouslander JG, Blaustein J, Connor A, Pitt A. Habit training and oxybutynin for incontinence in nursing home patients: a placebo-controlled trial. J Am Geriatr Soc. 1988;36(1):40–6.

    Article  CAS  PubMed  Google Scholar 

  76. Ouslander JG, Schnelle JF, Uman G, Fingold S, Nigam JG, Tuico E, et al. Does oxybutynin add to the effectiveness of prompted voiding for urinary incontinence among nursing home residents? A placebo-controlled trial. J Am Geriatr Soc. 1995;43(6):610–7.

    Article  CAS  PubMed  Google Scholar 

  77. Ouslander JG, Zarit SH, Orr NK, Muira SA. Incontinence among elderly community-dwelling dementia patients. Characteristics, management, and impact on caregivers. J Am Geriatr Soc. 1990;38(4):440–5.

    Article  CAS  PubMed  Google Scholar 

  78. By the American Geriatrics Society Beers Criteria Update Expert, P. American Geriatrics Society 2019 Updated AGS beers criteria(R) for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–94.

    Google Scholar 

  79. Ancelin ML, Artero S, Portet F, Dupuy AM, Touchon J, Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ. 2006;332(7539):455–9.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Carriere I, et al. Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study. Arch Intern Med. 2009;169(14):1317–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Low LF, Anstey KJ, Sachdev P. Use of medications with anticholinergic properties and cognitive function in a young-old community sample. Intl J Geriatr Psych. 2009;24(6):578–84.

    Article  Google Scholar 

  82. Campbell N, Boustani M, Limbil T, Ott C, Fox C, Maidment I, et al. The cognitive impact of anticholinergics: a clinical review. Clin Interv Aging. 2009;4:225–33.

    PubMed  PubMed Central  Google Scholar 

  83. Whalley LJ, Sharma S, Fox HC, Murray AD, Staff RT, Duthie AC, et al. Anticholinergic drugs in late life: adverse effects on cognition but not on progress to dementia. J Alzheimers Dis. 2012;30(2):253–61.

    Article  CAS  PubMed  Google Scholar 

  84. Jewart RD, Green J, Lu CJ, Cellar J, Tune LE. Cognitive, behavioral, and physiological changes in Alzheimer disease patients as a function of incontinence medications. Am J Geriatr Psychiatry. 2005;13(4):324–8.

    Article  PubMed  Google Scholar 

  85. Shiota T, Torimoto K, Momose H, Nakamuro T, Mochizuki H, Kumamoto H, et al. Temporary cognitive impairment related to administration of newly developed anticholinergic medicines for overactive bladder: two case reports. BMC Res Notes. 2014;7:672.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Green AR, Segal J, Tian J, Oh E, Roth DL, Hilson L, et al. Use of bladder Antimuscarinics in older adults with impaired cognition. J Am Geriatr Soc. 2017;65(2):390–4.

    Article  PubMed  Google Scholar 

  87. Lampela P, Taipale H, Hartikainen S. Use of cholinesterase inhibitors increases initiation of urinary anticholinergics in persons with Alzheimer's disease. J Am Geriatr Soc. 2016;64(7):1510–2.

    Article  PubMed  Google Scholar 

  88. Starr JM. Cholinesterase inhibitor treatment and urinary incontinence in Alzheimer's disease. J Am Geriatr Soc. 2007;55(5):800–1.

    Article  PubMed  Google Scholar 

  89. Kroger E, et al. Treatment with rivastigmine or galantamine and risk of urinary incontinence: results from a Dutch database study. Pharmacoepidemiol Drug Saf. 2015;24(3):276–85.

    Article  PubMed  Google Scholar 

  90. Gill SS, Mamdani M, Naglie G, Streiner DL, Bronskill SE, Kopp A, et al. A prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs. Arch Intern Med. 2005;165(7):808–13.

    Article  PubMed  Google Scholar 

  91. Hashimoto M, Imamura T, Tanimukai S, Kazui H, Mori E. Urinary incontinence: an unrecognised adverse effect with donepezil. Lancet. 2000;356(9229):568.

    Article  CAS  PubMed  Google Scholar 

  92. Triantafylidis LK, Clemons JS, Peron EP, Roefaro J, Zimmerman KM. Brain over bladder: a systematic review of dual cholinesterase inhibitor and urinary anticholinergic use. Drugs Aging. 2018;35(1):27–41.

    Article  CAS  PubMed  Google Scholar 

  93. Takusagawa S, Ushigome F, Nemoto H, Takahashi Y, Li Q, Kerbusch V, et al. Intestinal absorption mechanism of mirabegron, a potent and selective beta(3)-adrenoceptor agonist: involvement of human efflux and/or influx transport systems. Mol Pharm. 2013;10(5):1783–94.

    Article  CAS  PubMed  Google Scholar 

  94. Welk B, McArthur E. Increased risk of dementia among patients with overactive bladder treated with an anticholinergic medication compared to a beta-3 agonist: a population-based cohort study. BJU Int. 2020;126(1):183–90.

    Article  CAS  PubMed  Google Scholar 

  95. Gibson W, Johnson T, Kirschner-Hermanns R, Kuchel G, Markland A, Orme S, et al. Incontinence in frail elderly persons: report of the 6th international consultation on incontinence. Neurourol Urodyn. 2021;40(1):38–54.

    Article  PubMed  Google Scholar 

  96. Huion A, Decalf V, Kumps C, de Witte N, Everaert K. Smart diapers for nursing home residents with dementia: a pilot study. Acta Clin Belg. 2019;74(4):258–62.

    Article  PubMed  Google Scholar 

  97. Rose KM, Lach J, Perkhounkova Y, Gong J, Dandu SR, Dickerson R, et al. Use of body sensors to examine nocturnal agitation, sleep, and urinary incontinence in individuals with Alzheimer's disease. J Gerontol Nurs. 2018;44(8):19–26.

    Article  PubMed  Google Scholar 

  98. Ostaszkiewicz J. Reframing continence care in care-dependence. Geriatr Nurs. 2017;38(6):520–6.

    Article  PubMed  Google Scholar 

  99. Kohler M, Schwarz J, Burgstaller M, Saxer S. Incontinence in nursing home residents with dementia : influence of an educational program and nursing case conferences. Z Gerontol Geriatr. 2018;51(1):48–53.

    Article  PubMed  Google Scholar 

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  1. Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

    Adrian Wagg & Rebecca Lee

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Wagg, A., Lee, R. Urinary Incontinence in People Living with Cognitive Impairment. Curr Geri Rep 10, 124–131 (2021). https://doi.org/10.1007/s13670-021-00357-7

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