Longitudinal analysis of functional disabilities, cognitive decline and risk of dementia in women with Parkinson's disease and detrusor overactivity

Objectives: This long-term study exclusively in women with Parkinson's disease and urinary symptoms aimed to verify the correlation of urinary symptoms with motor severity of the disease and cognitive functions as well as analyze the functional abilities, mental functions and risk of dementia in patients with detrusor overactivity. Subjects and Methods: At baseline a cohort of 63 ambulatory patients with Parkinson's disease were evaluated for global disease severity, functional abilities and mental function using the Unified Parkinson's Disease Rating Scale (UPDRS) and Schwab & England scale (SES). Urologic function was assessed by International Prostatic Symptom Scale (IPSS) and urodynamic study. Two groups were then categorized at baseline: patients with and without detrusor overactivity. After seven years the same parameters were evaluated and the cognitive functions were assessed with the Montreal Cognitive Assessment (MoCA). Results: At baseline the lower urinary tract symptoms were correlated with the severity of the disease and the functional disabilities were significant in patients with detrusor overactivity. In the follow-up functional disabilities did not have different progression between the groups. There was a clear progression of mental scores, increased cognitive decline and risk of dementia in the group with detrusor overactivity. Conclusion: Detrusor overactivity is a prevalent urodynamic finding correlated with motor severity of the disease and associated with functional disabilities in women with Parkinson's disease. Patients with detrusor overactivity had in the long-term progression, a clear cognitive and mental function decline and increased risk of dementia. (C) 2020 Published by Elsevier Ltd.