Abstract
To evaluate the condition of incontinence in patients with senile dementia, we performed computed tomography X-rays to the brain and analyzed the relationship among the circulatory defect of the brain, the brain atrophy and the degree of incontinence. There were 92 patients subjected to this study who were hospitalised due to senile dementia; 74 patients had vascular dementia, 10 patients had senile dementia of Alzheimer type, and 8 patients had the mixed type. (age ranged: 54-95 years; mean: 80.3 years). The degree of incontinence in these patients varied as follows: 18 patients with continence, 16 patients with moderate incontinence, 58 patients with total incontinence. The diagnosis of circulatory defect of the brain was based on computed tomography observation of periventricular lucency (P. V. L.), and the degree of brain atrophy was evaluated based on 4 criteria: the Lateral body ratio, the Huckman number, the Evans ratio, and the enlargement of the subarachnoid space.
Among the 92 patients, P. V. L. was present in 31 patients, among them 27 patients suffered from incontinence. There was a significant correlation between P. V. L. and incontinence (p<0.001). As the incontinence progressively worsened (Continence, Moderate incontinence Total incontinence), the lateral body ratio increased to 24.8, 27.8, 28.6, (p<0.05). The Huckman number also increased to 18.3, 19.3, 21.3, (p<0.01), and the evans ratio likewise 29.9, 32.3, 33.7 (p<0.01). The enlargement of the subarachnoid space was also correlated with the severity of incontinence.
We conclude that urinary incontinence originating from senile dememtia is connected to brain atrophy and is strongly influenced by the circulatory disorders of the brain.
