Dementia

Urinary incontinence is a frequent and serious problem with dementia. After five years with the disease, every other dementia sufferer is affected by incontinence, and after eight years the total has risen to four out of five. A neurourological assessment and treatment may be useful in the early stage of the disease and help to prevent complications.

Alzheimer's disease is the most frequent cause of dementia in older people. There are approximately 100,000 people living in Switzerland with dementia, with around 20,000 new cases being diagnosed each year. The main symptoms are memory loss and speech impediments coupled with sensory dysfunctions, which progressively lead to an inability to perform the basic skills of everyday life. Urinary incontinence is a frequent and serious problem for dementia sufferers cared for at home and in some cases can be the trigger for entering a nursing home. After five years with the disease, every other dementia sufferer is affected by incontinence, and after just eight years that total has risen to four out of every five.

At the onset of the disease, incontinence is a result of the loss of memory in many cases: the sufferer forgets to go to the toilet or cannot find it. As the disease progresses, this is exacerbated by functional disorders of the bladder and urethral sphincter. This is caused by the demise of nerve cells and nerve tracts in the brain, entailing the loss of the ability to volitionally control the bladder.

A neurourological examination is recommended in the event of dysfunction when urinating or an involuntary leakage of urine. This is where it is possible to identify the underlying bladder control dysfunction and draw up a treatment plan. The treatment focuses primarily on behavioural and toilet training, which demands physical and mental support from relatives and nursing staff and should always take account of the individual situation of the person affected, his capabilities and limitations. Any treatment with medication in support of these activities requires regular check-ups by the doctor in order for any effects and side-effects to be observed.