Etiology and predictors of urinary incontinence and its effect on quality of life.

AIM: Urinary incontinence associated with dementia can result in medical comorbidities. We aimed to determine the prevalence of urinary incontinence and to identify the etiology and factors associated with urinary incontinence in dementia patients. METHODS: Patients with an Mini-Mental State Examination (MMSE) score of more than 10, attending the memory clinic were recruited. Basic demographic data, types and duration of dementia, use of cholinesterase inhibitor and other drugs with anticholinergic effects, carer stress and presence of urinary incontinence in the previous 6 months were recorded. Urodynamic studies were carried out in those patients with urinary incontinence. RESULTS: One hundred and forty-four subjects with a mean age of 78 years (standard deviation 6.8) were included. Forty-eight (33.3%) had urinary incontinence. There was no statistically significant difference between continent and incontinent groups regarding age, MMSE, duration of dementia, use of cholinesterase inhibitor and of drugs with anticholinergic effects. Presence of nocturia of more than twice per night (odds ratio [OR] 4, 95% confidence interval [CI] 1.7, 9.2), use of walking aids (OR 2.6, 95% CI 1.1, 5.9) and male sex (OR 1.36, 95% CI 1.1, 5.2) were independent predictors of urinary incontinence. Urodynamic studies showed that 21 subjects had detrusor overactivity, 13 had bladder outlet obstruction, two with low compliance bladder, two with small bladder capacity, four with detrusor hyperactivity and impaired contractility. CONCLUSION: Urinary incontinence commonly occurs in dementia subjects. Poor mobility and presence of nocturia increase the risk of urinary incontinence. Correction of the possible reversible factors may help to reduce the prevalence of urinary incontinence in patients with dementia and reduce carer stress.

Curcumin effects on blood lipid profile in a 6-month human study.

Studies in animals and a short-term human study have suggested that curcumin, a polyphenolic compound concentrated in the curry spice turmeric, decreases serum cholesterol concentration. However, no controlled human trials have examined the effect of curcumin on cholesterol. This study investigated the effects of consuming curcumin on the serum lipid profile in men and women. Elderly subjects (n=36) consumed 4 g/d curcumin, 1g/d curcumin, or placebo in a 6-month, randomized, double-blind trial. Plasma curcumin and its metabolites were measured at 1 month, and the serum lipid profile was measured at baseline, 1 month, and 6 months. The plasma curcumin concentration reached a mean of 490 nmol/L. The curcumin concentration was greater after capsule than powder administration. Consumption of either dose of curcumin did not significantly affect triacylglycerols, or total, LDL, and HDL cholesterol over 1 month or 6 months. However, the concentrations of plasma curcumin and serum cholesterol were positively and significantly correlated. Curcumin consumption does not appear to have a significant effect on the serum lipid profile, unless the absorbed concentration of curcumin is considered, in which case curcumin may modestly increase cholesterol.