Alzheimer's disease effects a large percentage of elderly
dementia patients and is diagnosed on the basis of
amyloid plaques and neurofibrillary tangles (NFTs) present in the brain.
Urinary incontinence (UI) is often found in the elderly populations and multiple studies have shown that it is more common in
Alzheimer's disease patients than those with normal cognitive function. However, the link between increased UI and
Alzheimer's disease is still unclear.
Amyloid plaques and NFTs present in micturition centers of the brain could cause a loss of signal to the bladder, resulting in the inability to properly void. Additionally, as
Alzheimer's disease progresses, patients become less likely to recognize the need or understand the appropriate time and place to void. There are several treatments for UI targeting the
muscarinic and β3
adrenergic receptors, which are present in the bladder and the brain. While these treatments may aid in UI, they often have effects on the brain with
cognitive impairment side-effects.
Acetylcholine esterase inhibitors are often used in treatment of
Alzheimer's disease and directly oppose effects of anti-
muscarinics used for UI, making UI management in
Alzheimer's disease patients difficult. There are currently over 200 pre-clinical models of
Alzheimer's disease, however, little research has been done on voiding disfunction in these models. There is preliminary data suggesting these models have similar voiding behavior to
Alzheimer's disease patients but much more research is needed to understand the link between UI and
Alzheimer's disease and discover better treatment options for managing both simultaneously.