Associations of Self-Rated Deficits in Executive Function with Lower Urinary Tract Symptoms, Adaptive Behaviors, and Bladder Health among Women.

Background: Poorer performance on standardized tests of cognitive function is associated with urinary incontinence (UI), overactive bladder, and poorer bladder health among people aged 40 and older. Objective: To examine whether self-rated deficits in executive function domains (organization/problem solving, inhibitory control/self-restraint, self-regulation of emotions) are associated with lower urinary tract symptoms (LUTS), perceived bladder health and function, and adaptive behaviors to prevent or manage UI among adult women across the life course. Methods: Surveys were administered as part of the RISE FOR HEALTH population-based study of women (19-100 years, mean = 50 years) in the United States. In this cross-sectional analysis, LUTS, perceived bladder health and function, and adaptive behaviors were regressed on individual executive function subscales and a composite measure (analytic sample n = 1,551). Results: Self-rated deficits in all evaluated domains of executive function were significantly associated with greater numbers and frequency of LUTS, including urgency and urgency UI; poorer perceived bladder health and function; and a greater tendency to locate bathrooms when entering new places. Associations were of similar magnitude across age categories ranging from emerging to older adulthood. Conclusions: Findings demonstrate an association between self-rated executive function deficits and bladder function. Further research should test brain-bladder communication as a potential mechanism linking deficits in executive function to greater numbers and frequency of LUTS, poorer perceived bladder health and function, and greater engagement in adaptive behaviors to prevent or manage UI. Research is also needed to further evaluate whether associations between executive function and LUTS differ by life course stage.