Is Strong Desire to Void an Equivalent of Cognitive Task Affecting Balance in Older Women With Overactive Bladder?

Falls have multifactorial etiologies in older people. Lower urinary tract symptoms (LUTS) are one of those, with an increase prevalence over years (30% of people over 75 years old have overactive bladder [OAB]). Previous studies showed that older women with oAB with or without urinary incontinence (UI) are prone to have gait disorders (decrease of gait speed and step width and increase of number of step). Besides UI, it is more likely the strong desire to void (SDV) that seems to impact gait and balance control. In older women with UI, balance on stabilometric parameters has been affected with an increase of the center of pression (COP) sway range, COP area and rambling trajectory. SDV seems to act like an additional cognitive task.

A similar and increased reaction time has been observed in comparing with a distracting task in healthy volunteers. In older people who are susceptible to distracting task, SDV may alters balance and gait.

The primary objective of this prospective study is to assess the impact of SDV on stabilometric parameters (center of foot pressure (COP) area, the distance travelled made by COP, the mean X-axis displacement and the mean Y-axis displacement) compared to the "empty bladder" condition.

The secondary objectives are assessing the impact of a cognitive task (verbal fluency) on stabilometric parameters in comparison with the "no cognitive task condition" and the "SDV condition"; and assessing the impact of "SDV condition" on balance and gait clinical evaluation (Timed up and go test, unipedal stance test, Berg scale, 10m walking speed, 5 chair stand) This prospective study will take place in a rehabilitation department during a 2hours-consultation. The eligible criteria are: women over 65 years old, with OAB with or without UI, able to walk without mobility equipment without neurologic pathology or spine surgery, without severe cognitive impairment (MMSE > 24) or legal protection, and who agree to be involved in the study. OAB was defined by urinary urgency, usually with urinary frequency and nocturia, with or without urgency urinary incontinence.

The included women will first have a standard urinary consultation in which comorbidities, treatments and urinary symptoms will be recorded. Participants will also have questionnaires on urinary symptoms (Urinary Symptom Profile and Incontinence Consultation Incontinence Questionnaires) and the Mini Mental Status Examination (assessing cognitive functions).