Urinary Incontinence, Incident Parkinsonism, and Parkinson's Disease Pathology in Older Adults

Noa M. Buchman, Sue E. Leurgans, Raj J. Shah, Veronique VanderHorst, Robert S. Wilson, Yaacov G. Bachner, David Tanne, Julie A. Schneider, David A. Bennett, Aron S. Buchman

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective: To test the hypothesis that urinary incontinence (UI) is associated with incident parkinsonism in older adults.

Methods: We used data from 2,617 older persons without dementia. Assessment included baseline self-report UI and annual structured exam which assessed parkinsonian signs, motor performances, cognitive function, and self-report disabilities. We used a series of Cox proportional hazards models to examine the association of UI with parkinsonism and adverse health outcomes and a mixed-effect model to examine the association of UI with the annual rate of cognitive decline. In decedents, regression models were used to examine if UI proximate to death was related to postmortem indices of neuropathologies.

Results: At baseline, more than 45% of participants reported some degree of UI. Over an average of nearly 8 years of follow-up, UI was associated with incident parkinsonism (hazard ratio [HR] = 1.07, 95% CI = 1.02, 1.12), death (HR = 1.07, 95% CI = 1.03, 1.11), incident ADL disability (HR = 1.11, 95% CI = 1.07, 1.16), and incident mobility disability (HR = 1.07, 95% CI = 1.02, 1.13). UI was not related to incident MCI (HR = 1.02, 95% CI = 0.97, 1.07), incident AD dementia (HR = 1.00, 95% CI = 0.95, 1.05) or to the rate of cognitive decline (Estimate = -.002, standard error = .002, p = .167). In 1,024 decedents with brain autopsy, UI proximate to death was related to PD pathology (Lewy body pathology and nigral neuronal loss), but not Alzheimer's disease pathology or other age-related neuropathologies.

Conclusion: UI in older adults is associated with incident parkinsonism and may identify older adults at risk for accumulating PD brain pathology.

Original languageEnglish
Pages (from-to)1295-1301
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume72
Issue number9
DOIs
StatePublished - 1 Sep 2017
Externally publishedYes

Funding

FundersFunder number
National Institute on AgingRF1AG015819
National Institute on Aging

    Keywords

    • Aging
    • Brain pathology
    • Cognition
    • Disability
    • Mortality
    • Urinary incontinence

    Fingerprint

    Dive into the research topics of 'Urinary Incontinence, Incident Parkinsonism, and Parkinson's Disease Pathology in Older Adults'. Together they form a unique fingerprint.

    Cite this