PD34-04 IMPACT OF COGNITIVE FUNCTION IN OLDER PATIENTS UNDERGOING SACRAL NEUROMODULATION FOR OVERACTIVE BLADDER: A PROSPECTIVE STUDY

Abstract

You have accessJournal of UrologyCME1 May 2022PD34-04 IMPACT OF COGNITIVE FUNCTION IN OLDER PATIENTS UNDERGOING SACRAL NEUROMODULATION FOR OVERACTIVE BLADDER: A PROSPECTIVE STUDY Jacqueline Zillioux, Sarah Martin, Lauren Gleich, Glenn T. Werneburg, Emily Slopnick, Raymond R. Rackley, Sandip Vasavada, Bradley Gill, and Howard B. Goldman Jacqueline ZilliouxJacqueline Zillioux More articles by this author , Sarah MartinSarah Martin More articles by this author , Lauren GleichLauren Gleich More articles by this author , Glenn T. WerneburgGlenn T. Werneburg More articles by this author , Emily SlopnickEmily Slopnick More articles by this author , Raymond R. RackleyRaymond R. Rackley More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , Bradley GillBradley Gill More articles by this author , and Howard B. GoldmanHoward B. Goldman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002585.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Overactive bladder (OAB) and cognitive impairment (CI) are both increasingly prevalent with age. Given the association between anticholinergics and dementia, there is need to optimize other therapies. SUFU/AUA OAB guidelines cite adequate cognitive function as necessary for sacral neuromodulation (SNM); however, the impact of CI on SNM in older patients remains unknown. This is an interim analysis of a prospective study assessing the impact of cognitive function on outcomes of SNM for refractory OAB. METHODS: With IRB-approval, we recruited patients aged ≥60 years scheduled for test-phase (peripheral nerve evaluation (PNE) or stage 1) SNM for refractory OAB. Baseline cognitive function was assessed using the validated Montreal Cognitive Assessment (MoCA) screening test. Scores ≥26/30 are considered normal and <26 considered CI. Patients completed validated questionnaires (OAB-q SF, IIQ7, UDI-6, PGI-I) at baseline and 1-month follow-up (if implanted). Number of program adjustments performed by the patient and whether patients demonstrated appropriate device use (i.e. familiarity with communicator/programmer) were recorded. Implant rate, patient-reported questionnaires, and SNM utilization were compared based on MoCA/CI. RESULTS: 27 patients underwent test-phase (17 PNE, 10 Stage 1). Mean age was 71.9 (6.7) years. Median baseline MoCA was 24 [21.5,26.5], ranging 14-29. Although 5 (19%) patients had a pre-existing CI diagnosis, 16 (59%) demonstrated CI per MoCA. The table compares patient characteristics, baseline questionnaires and utilization outcomes based on CI. Overall, 23 (85%) patients underwent permanent implant after successful test-phase. Implant rates did not differ based on MoCA or CI. Among 15 patients with 1-month follow-up, those demonstrating appropriate device use had significantly higher MoCA scores (26 vs 17, p=0.004). Postoperative change in validated questionnaires scores, however, did not differ. CONCLUSIONS: Despite few pre-existing diagnoses, there is a high incidence of CI in older patients with OAB undergoing SNM. While implant rate did not differ based on MoCA/CI, patients with lower MoCA scores were less likely to demonstrate appropriate device use on follow-up. Impact on clinical efficacy of SNM remains to be determined. Source of Funding: Medtronic © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e560 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jacqueline Zillioux More articles by this author Sarah Martin More articles by this author Lauren Gleich More articles by this author Glenn T. Werneburg More articles by this author Emily Slopnick More articles by this author Raymond R. Rackley More articles by this author Sandip Vasavada More articles by this author Bradley Gill More articles by this author Howard B. Goldman More articles by this author Expand All Advertisement PDF DownloadLoading ...