This report shows the relation between daily activities, dementia and urinary disturbance. The subjects consisted of 44 males and 110 females with an average age of 80 years (ranged from 57 to 102). We evaluated the daily activities, underlying diseases, state of urination and the intelligence by the scale of Hasegawa. The persons with diapers had a higher degree of dementia than those who could go to the lavatory. As the degree of dementia aggravated, the incidence of urinary incontinence significantly increased. Urodynamic studies were performed on 49 persons who had urinary disturbance. There were 25 persons with normal vesical function, 16 with overactive vesical function, and 8 with underactive vesical function. Since all of the incontinent persons without dementia had abnormal vesical function, pharmacologic therapy was expected to be effective for them to improve incontinence. Half of the incontinent persons with dementia had normal vesical function. Mental and physical disabilities seemed to be the main factors causing incontinence in these persons. The multidisciplinary approach including medication, behavior treatment and awareness of the nursing staff is important and effective to reduce urinary incontinence.
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