Cognitive function modestly tied to lower urinary tract symptoms for midlife women

Key takeaways:

• Cognitive function was linked to less likelihood of lower urinary tract symptoms.
• Associations weakened after adjusting for mechanisms that may explain links between cognition and lower urinary tract symptoms and impact.

For midlife women, better cognitive function — specifically ability, attention, processing speed and executive function — was associated with a lower likelihood of lower urinary tract symptoms, researchers reported in Menopause.

“It is an intuitive premise that cognitive function may influence the bladder health of women. The brain receives and interprets signals about degree of urge from the bladder; it also exerts voluntary control over storage and emptying,” Sonya S. Brady, PhD, LP, associate professor in the department of family medicine and community health in the Program in Health Disparities Research at the University of Minnesota Medical School, and colleagues wrote. “Aspects of cognitive function — particularly executive function — may impact brain-bladder communication and women’s bladder health.”

Brady and colleagues evaluated data from 1,021 women (mean age, 50 years) in the Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort study from 2010 to 2011. All women completed different cognitive function tests, including the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test and Stroop test. Researchers collected data on lower urinary tract symptoms and their impact 2 years later.

More than 75% of women were classified as having mild lower urinary tract symptoms. In addition, 60% of women reported urinary incontinence of any amount in the past 3 months, and more than 40% reported waking two or more times nightly to void in the past month.

Researchers observed worse cognitive performance scores among women classified as having severe lower urinary tract symptoms.

Better performance on the cognitive function composite and Digit Symbol Substitution Test were associated with lower odds of more severe lower urinary tract symptoms (OR = 0.9; 95% CI, 0.83-0.98) and their impact 2 years later (OR = 0.89; 95% CI, 0.82-0.97) when adjusting for sociodemographics and gynecologic/obstetric variables. Cognitive performance scores 1 standard deviation higher for the cognitive function composite and Digit Symbol Substitution Test were associated with 10% and 11% lower odds of more severe lower urinary tract symptoms.

However, these associations were not significant when also adjusting for mechanisms possibly explaining associations between cognitive function and lower urinary tract symptoms, the researchers wrote.

“These findings contribute to a small literature suggesting that aspects of cognitive function are related to brain-bladder communication,” the researchers wrote. “Longitudinal studies are needed to further investigate these associations and potential explanatory mechanisms, including cerebral and peripheral vascular health, autonomic nervous system and hypothalamic-pituitary-adrenal axis function, neurotransmitter activity and inflammation.”