Frontal executive function and the bladder: A study of dementia with Lewy bodies

Abstract

AbstractBackgroundPathophysiology of bladder dysfunction in dementia with Lewy bodies (DLB, a disease that shares pathology with Parkinson's disease [PD]) is disturbed prefrontal‐basal ganglia pathway. Similarly, DLB/PD patients have frontal executive dysfunction by the same mechanism.AimTo study the relationship between executive function and bladder autonomic function in patients with DLB.MethodsWe recruited 45 patients with DLB (28 male, 17 female; age 73.3 years ± 6.8). Other neurologic, urologic, and systemic causes of cognitive and bladder dysfunctions were excluded. All patients underwent urodynamics tests and three sets of cognitive tasks (i.e. the mini‐mental state examination [MMSE], Alzheimer's disease assessment scale cognitive [ADAScog; general cognitive tasks], and the frontal assessment battery [FAB; frontal executive tasks]).ResultsThe urinary questionnaire revealed urinary incontinence in 20 patients. Urodynamic testing revealed detrusor overactivity (DO) in 30 patients. Cognitive testing found patients’ mean MMSE score to be 22.6 ± 4.8, while their mean FAB score was 11.5 ± 2.6. There was no relationship between DO and total MMSE score. However, our analysis revealed a significant relationship between DO and total FAB score (P < 0.05).ConclusionThe results showed that performance on the FAB test decreased in DLB patients with bladder dysfunction.