Identifying types of non-pharmacological interventions administered by healthcare providers for older adults with neurocognitive disorders who have lower urinary tract symptoms: A scoping review.

Abstract

Aims: Older adults with neurocognitive disorders (NCDs) often experience lower urinary tract symptoms (LUTS), which reduce quality of life (QOL) and increase care needs. Although non-pharmacological interventions are recommended, their types and applications have not been comprehensively synthesized by severity levels or care settings. This scoping review aimed to identify the types of non-pharmacological interventions administered by healthcare providers for older adults with NCDs who have LUTS, and to classify them by severity levels and care settings. This represents the first comprehensive attempt to organize this information, providing foundational data for developing clinical implementation models.

Methods: This review followed the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A systematic search of PubMed, Embase, CINAHL Ultimate, and ICHUSHI Web was conducted for studies published through July 31, 2024. Eligible studies included participants aged 65 years or older with NCDs and LUTS. These interventions were categorized by type and mapped according to the severity of NCDs.

Results: Eighteen studies met the inclusion criteria. Interventions were categorized into individualized, behavioral, cognitive, and educational interventions, based on the severity levels of NCD. Individualized voiding schedules, care plans, and caregiver education were employed across care settings.

Conclusion: Non-pharmacological interventions were mapped into four types based on categories and severity levels of NCD. In milder conditions, interventions emphasized self-management, such as pelvic floor muscle exercises and cognitive stimulation therapy. In more advanced conditions, caregiver-led interventions and assistive technologies such as sensors and bladder scanners were employed.