title: Frontal white matter hyperintensity predicts lower urinary tract dysfunction in older adults with amnestic mild cognitive impairment and Alzheimer's disease.
abstract: OBJECTIVE
  Lower urinary tract symptoms often limit activities of daily life and impair quality of life in the elderly. The purpose of the present study was to determine whether regional white matter hyperintensity (WMH) can predict lower urinary tract symptoms in elderly with amnestic mild cognitive impairment or Alzheimer's disease.
  
  
  METHODS
  The participants were 461 patients aged 65-85 years diagnosed with amnestic mild cognitive impairment or Alzheimer's disease. Patients and their caregivers were asked about symptoms of lower urinary tract symptoms (urinary difficulty, frequency and incontinence). Cognition, behavior and psychological symptoms of dementia and medication were evaluated. WMH and brain atrophy were analyzed using an automatic segmentation program. Regional WMH was evaluated in the frontal, parietal, temporal and occipital lobes.
  
  
  RESULTS
  Patients with urinary incontinence showed significantly greater volume of WMH. WMH increased with age, especially in the frontal lobe. WMH in the frontal lobe was closely associated with urinary incontinence after adjustment for brain atrophy and classical confounding factors.
  
  
  CONCLUSIONS
  Frontal WMH was a predictive factor for urinary incontinence in older adults with amnestic mild cognitive impairment or Alzheimer's disease. Urinary incontinence in demented older adults is not an incidental event, and careful insight into regional WMH on brain magnetic resonance imaging might greatly help in diagnosing individuals with a higher risk of urinary incontinence.
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.|Biobank, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Ogama
authors.affiliation: Department of Urology, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: NeuroImaging and Informatics, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Nakai
authors.affiliation: Biobank, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Shumpei
authors.initials: S
authors.lastname: Niida
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Toba
authors.affiliation: Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D000647:Amnesia / Q000150:complications*; D060825:Cognitive Dysfunction / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D066127:White Matter / Q000473:pathology*
keywords: Alzheimer's disease; lower urinary tract symptoms; mild cognitive impairment; urinary incontinence; white matter hyperintensity