Data extraction

Duplicate data were extracted independently (RH & TM) using a standard spreadsheet, which captured information on study design, population, and the association between cognitive dysfunction and nocturia. A summary is provided in the results section (Tables 1 & 2).

Study characteristics

858 outpatients admitted to a

geriatric center

Female: 100%

Mean (sd) age: 74.1 (8.2) years

“Generally, during the past

30 days, how many times do you usually urinate after you have gone to sleep at night until the time you got up in the morning?”

Cut-off: 1, 2, 3, 4 or more

Prevalence: 19.0, 24.2, 18.4, and 24.1% respectively

MMSE and Dementia diagnosed using the DSM V

Mean (sd) MMSE score: 24.7 (4.9), 25.0 (4.2), 24.9 (3.7), 24.2 (4.4), 23.9 (4.9) in patients with 0, 1, 2, 3 or ≥ 4 nocturia episodes respectively

Prevalence (dementia): 4.4%

376 patients with probable Alzheimer’s disease

Female: 51.1%

Age range: 56–92 years

OABSS

Mean (sd) number of nocturia episodes: 1.2 (0.8), 1.2 (0.9) and 1.6 (1.0) in patients with OABSS ≤5, 6–11 or ≥ 12 respectively

Prevalence: NR

MMSE and CDR scale

Mean (sd) MMSE score: 14.4 (7.6) in patients with OAB

Mean (sd) CDR score: 2.3 (0.9) in patients with OAB

454 patients with Parkinson’s disease

Female: 42.7%

Mean (sd) age: 61.5 (10.9) years

NMSS

Mean (sd) NMSS score for nocturia: 2.4 (3.3)

Cut-off: NR

Prevalence: 47.2%

MoCA

Mean (sd) MoCA score: 23.7 (4.5)

Prevalence (MoCA ≤25): 58.1%

143 patients with Parkinson’s disease

Female: 35%

Mean (sd) age: 64.7 (9.0) years

“When you awaken during the night, how often do you urinate?” on sleep questionnaire drawn from existing studies; Nocturia frequency evaluated on 4-point Likert scale (1 = “never,” 4 = “very often”)

Prevalence: NR

Impulsivity determined by at least 1 “yes” to the Minnesota Impulse Disorder Interview (MIDI) questions

Prevalence: 26.6%

63 patients with Parkinson’s disease

Female: 35%

Mean (sd) age: 63 (9.7) years

IPSS

Cut-off: ≥2 voids/nights

Prevalence: 61%

MMSE

Mean (sd) MMSE score: 28.6 (1.5) in patients without nocturia and 28.5 (1.9) in patients without

Prevalence: NR

1288 community-dwelling individuals

Female: 57%

Mean (sd) age: 74.2 (6.3) years

History taking

Cut-off: ≥2 voids/nights

Prevalence: 45.8%

MMSE

Mean (sd) MMSE score: 25.3 (4.8)

Prevalence: NR

299 community-dwelling men

Mean (sd) age: 71.2 (5.0) years

History taking

Cut-off: ≥2 voids/nights

Prevalence: 56.0%

MMSE

Mean (sd) MMSE score: 25.6 (3.4)

Prevalence: NR

1000 Medicare beneficiaries

Female: 50%

Mean (sd) age: 73.8 (NR) years

History taking

Cut-off: ≥2 voids/nights

Prevalence: 58.5%

MMSE

Mean (sd) MMSE score: 25 (4.9)

Prevalence (MMSE < 24): 29.8%

BPH Benign prostatic hypertrophy, CI Confidence interval, CDR Clinical Dementia Rating; DSM Diagnostic and Statistical Manual of Mental Disorders, HAMA Hamilton Anxiety Rating Scale, HAMD Hamilton Depression Rating Scale, IPSS International Prostate Symptom Score, MoCA Montreal Cognitive Assessment, MMSE Mini-Mental State Examination, NMSS Non-Motor Symptom Scale, NR Not reported, OABSS Overactive Bladder Symptom Score, OR Odds ratio, r Correlation coefficient, sd Standard deviation, UPDRS Unified Parkinson’s Disease Rating Scale

Association between cognitive dysfunction and nocturia

Lower MMSE scores in patients with ≥2 nocturia episodes compared to those with < 2 episodes; MCID observed only for the group with at least 4 nocturnal voids compared to the group with 1 nocturnal void

No difference in dementia prevalence

No significant correlation between nocturia and MMSE

Significant correlation between nocturia and CDR scale: r = 0.23; MCID: not assessable

Significant difference of nocturia prevalence in patients with cognitive dysfunction vs. without 56.3% vs. 36.8%.

Mean (sd) NMSS nocturia sub-score significantly higher in patients with cognitive dysfunction vs. without 2.9 (3.4) vs. 1.7 (3.0); MCID: not assessable

MMSE protective factor of nocturia with OR 0.9 (CI non available)

MCID not assessable

BPH Benign prostatic hypertrophy; CI Confidence interval, CDR Clinical dementia rating scale (MCID: 1–2 point increase indicative of a meaningful decline), HAMA Hamilton Anxiety Rating Scale, HAMD Hamilton Depression Rating Scale, MCID Minimal clinically important difference, MMSE Mini-Mental State Examination (MCID: 1–3 point decrease indicative of a meaningful decline), NMSS Non-Motor Symptom Scale (MCID: 13.91 point increase indicative of a meaningful change), OR Odds ratio, r Correlation coefficient, sd standard deviation, UPDRS Unified Parkinson’s Disease Rating Scale

Variables included in multivariable analysis:

^aAge, age of onset, gender, education level, scores of speech, facial expression, tremor, rigidity, bradykinesia and axial impairment in the UPDRS, total HAMD and HAMA scores, presence of sleep/ fatigue, perceptual problems/hallucinations, attention/memory, gastrointestinal domains from NMSS

^bHistory of BPH, age, education, depression, alpha-blocker, transitional zone volume of prostate

^cAge, ethnicity, obesity, urban status (vs rural)

^dAge, ethnicity, hypertension, lower limb oedema, history of urinary incontinence, urban status (vs rural)