Executive Function Is Related to the Urinary Urgency in Non-demented Patients With Parkinson's Disease

Introduction: Urinary urgency has been linked to cognitive impairment in a subgroup of patients with Parkinson’s disease (PD). This study examined whether cognitive deficits independently predict urinary dysfunction in PD.

Methods: Data from 189 idiopathic PD patients were analyzed, excluding individuals with comorbidities or medications affecting bladder function. Urinary urgency was assessed using a standardized questionnaire. All participants underwent comprehensive motor, cognitive, non-motor, and health-related quality of life (HRQoL) assessments. Multivariable regression analyses identified independent predictors of PD-related urinary urgency (PD-UU), and discriminant analysis evaluated their combined predictive value.

Results: Urinary urgency was reported by 115 patients (60.8%). Regression analysis revealed a significant negative association between executive function and PD-UU. In a second model, global cognition (MoCA score) and non-motor symptom burden significantly differentiated patients with and without PD-UU. In the HRQoL model, stigma was the only PDQ-39 subscale associated with urinary urgency. Discriminant analysis showed that executive function, non-motor symptom burden, nocturia, and stigma classified PD-UU status with 72.4% accuracy.

Conclusion: In this large, non-demented PD cohort, urinary urgency was independently associated with executive dysfunction, suggesting a potential causal relationship. A combination of cognitive and non-motor features reliably distinguished patients with urinary urgency, highlighting the importance of integrated assessment in PD.