Cognitive Function

Some degree of cognitive function is required to recognize the need to urinate and be able to satisfy that need in a socially acceptable way. However, confusion must usually be severe to produce incontinence, unless there are coexisting problems. In Alzheimer’s disease, incontinence usually occurs late, when the patient is severely demented. If incontinence occurs with mild or moderate dementia, it may indicate either another kind of dementia, e.g., multi-infarct dementia or normal pressure hydrocephalus, or that another problem is present affecting the urinary tract. Cognitive function may be impaired in acute illness or stress and may cause acute incontinence. Since incontinence in demented persons is often a treatable problem, either by treating the specific problem or by using behavioral approaches, a workup should be done and treatment attempted.