Influence of current state of executive function and working memory on adherence to antimuscarinic therapy in older women with OAB

Aim: Evaluation of the executive function and working memory influence, as well as the general state of memory, on adherence to treatment with antimuscarinic drugs in elderly women with overactive bladder (OAB).

Background: Antimuscarinic are effective and safe for the treatment of OAB, but adherence to treatment remains low. Demographic, socioeconomic, and medical factors which influence the medication adherence have been explored; however, the impact of executive function and working memory on adherence has not been evaluated yet.

Methods: In total 417 women from 65 to 88 years old with the diagnosis overactive bladder were selected to participate in the study. They were prescribed AM drugs: trospium 15 mg / day (n = 138), or Solifenacin 5 mg / day (n = 132), or Darifenacin 7.5 mg / day (n = 147). The observation was carried out for 12 weeks. The urodynamic state was investigated using the questionnaire OABq-SF, uroflowmetry was performed at the start and end of the study, voiding diary - during the whole time of observation. The state of mental health was investigated using MMSE and GDS. The assessment of executive function and working memory, as well as general memory estimation, was carried out using the Wisconsin Card Sorting Test, Wechsler Memory Scale subscale, and the California Verbal Learning Test. Hierarchical and simultaneous regressions were calculated to study the effect of executive function and working memory on medication adherence.

Results: The urodynamic state of patients significantly improved after the treatment, the cognitive functions did not change. The analysis of hierarchical and simultaneous regressions made it possible to establish that the predictor variables significantly influencing medication adherence of elderly women with OAB to AM treatment are executive function and working memory composite (β = .39, p < .05), severe symptoms of lower urinary tract (β =. -. 31, p < .05), and age (β =. -. 25, p < .05).

Conclusion: The status of executive function and working memory, as well as the age and severity of the pathological symptoms of lower urinary tract should be considered when predicting adherence to AM treatment in elderly patients with OAB.