Cognitive Impairment and Pelvic Floor Disorders

AbstractPurpose of ReviewCognitive impairment and pelvic floor disorders (PFDs) more frequently affect older women. We aimed to review recent literature on challenges of providing treatment for women with pelvic floor disorders and cognitive impairment, including risks to those with cognitive impairment, challenges in treatment, and non-pharmacologic treatment options.Recent FindingsPrevalence of cognitive impairment in women seeking PFD treatment ranges between 4.3 and 29.3%. Women with cognitive impairment and urgency incontinence are at risk of cognitive changes from antimuscarinics, and polypharmacy in treatment of incontinence as an adverse effect from acetylcholinesterase inhibitor treatment for dementia. Additionally, older age and cognitive impairment appear to be risk factors for poorer surgical outcomes in urogynecologic surgery. There are no non-pharmacologic care methods with strong evidence to show improved outcomes in women with PFDs and cognitive impairment.SummaryWe are improving our understanding of the challenges in caring for women with urgency incontinence and cognitive impairment, but data is lacking regarding the care of these patients who have pelvic organ prolapse and anal incontinence. More research of interventions to help caregivers is needed to provide directive guidelines that could improve PFD outcomes and caregiver experience.

Source: Current Obstetrics and Gynecology Reports - September 5, 2017 Category: OBGYN Source Type: research