title: Management of LUTS in patients with dementia and associated disorders .
abstract: To systematically review the management of lower urinary tract symptoms (LUTS) in patients with dementia and associated disorders.
  
  
  
  This systematic review was performed according to the PRISMA statement. Studies were identified by electronic search of Embase and Medline databases (last search August 2015) and by screening of reference lists and reviews.
  
  
  
  Of 1,426 abstracts that were screened, 102 full-text articles were identified and assessed for eligibility. Seventy-six articles were then included in the quantitative synthesis. Urinary incontinence (UI) prevalence rates in dementia patients have varied considerably, ranging from 11 to 93%. In Alzheimer's disease patients, UI usually correlates with disease progression (late-stage dementia). In contrast, LUTS usually precede severe mental failure in Lewy body disease and in vascular dementia. Behavioral therapy, including toilet training and prompted voiding, may be especially useful in patients with unawareness UI. High-quality data to guide the choice of treatment strategies in this population are lacking. Current evidence suggests that antimuscarinics, especially oxybutynin, can be associated with cognitive worsening, due to the blockade of M1 receptors. Thus, the use of antimuscarinics that do not easily cross the blood-brain barrier or are more M2/M3 selective should be considered. No data are available for beta-3 agonists so far.
  
  
  
  Different types of dementia cause different LUTS at varying time points during the disease process and need singular therapeutic approaches. Treatment of LUTS should be tailored to individual patient needs and disease status, considering factors like mobility, cognitive function, and general medical condition. Neurourol. Urodynam. 36:245-252, 2017. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, Moinhos de Vento Hospital, Porto Alegre, Brazil.
authors.forename: Márcio Augusto
authors.initials: MA
authors.lastname: Averbeck
authors.affiliation: King Faisal Specialist Hospital and Research Center, Alfaisal University, Riyadh, Saudi Arabia.
authors.forename: Waleed
authors.initials: W
authors.lastname: Altaweel
authors.affiliation: Spitalul Prof D Gerota, Bucharest, Romania.
authors.forename: Andrei
authors.initials: A
authors.lastname: Manu-Marin
authors.affiliation: Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Helmut
authors.initials: H
authors.lastname: Madersbacher
mesh_terms: D000544:Alzheimer Disease / Q000150:complications*; D003704:Dementia / Q000150:complications*; D019468:Disease Management; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000188:drug therapy*; D018727:Muscarinic Antagonists / Q000627:therapeutic use*
chemical_list: D018727:Muscarinic Antagonists
keywords: LUTS; dementia; systemic review