ABSTRACT
This chapter reviews prevalence, etiology, mechanism, and management of lower urinary tract (LUT) dysfunction associated with dementia. Among adults older than 60 years, urinary incontinence is twice as common in women as in men, reflecting anatomic differences in the urethra and the pelvic floor muscles that lead to stress urinary incontinence. Alzheimer's disease is the most common cause of severe dementia in the elderly and accounts for more than 50% of dementia patients. Dementia with Lewy bodies is the second most common degenerative cause of dementia. Lewy bodies are cytoplasmic inclusion bodies, and they appear to be widespread in the cerebral cortex and basal ganglia in patients with this disorder. Functional incontinence is the major cause of urinary incontinence in dementia. It refers to incontinence that is not derived from an abnormality in the LUT or its innervation, but from immobility, cognitive disability, and decreased motivation.
