PD59-12 DOES COGNITIVE IMPAIRMENT IMPACT SACRAL NEUROMODULATION SUCCESS IN OLDER ADULTS?
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Résumé
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neuromodulation (PD59)1 May 2024PD59-12 DOES COGNITIVE IMPAIRMENT IMPACT SACRAL NEUROMODULATION SUCCESS IN OLDER ADULTS? Chen Shenhar, Howard B. Goldman, Jacquelyn Booher, Lauren Gleich, Omer Anis, Tyler Trump, Emily Emily, Bradley Gill, and Jacqueline Zillioux Chen ShenharChen Shenhar , Howard B. GoldmanHoward B. Goldman , Jacquelyn BooherJacquelyn Booher , Lauren GleichLauren Gleich , Omer AnisOmer Anis , Tyler TrumpTyler Trump , Emily EmilyEmily Emily , Bradley GillBradley Gill , and Jacqueline ZilliouxJacqueline Zillioux View All Author Informationhttps://doi.org/10.1097/01.JU.0001009544.34256.8a.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Overactive bladder (OAB) and cognitive impairment (CI) are both increasingly prevalent with age. Concern regarding the cognitive safety of anticholinergic OAB medications has highlighted the importance of optimizing alternative safe and effective therapies in older patients with OAB, including those with cognitive impairment (CI). The objective of this study is to assess the impact of cognitive function on sacral neuromodulation (SNM) outcomes in older patients. METHODS: This is an IRB-approved prospective study. Patients aged ≥60 years scheduled for test-phase (peripheral nerve evaluation (PNE) or stage 1) SNM for refractory OAB were recruited. Cognitive function was assessed using the validated Montreal Cognitive Assessment (MoCA) tool, with scores <26/30 considered CI. Patients underwent initial and follow-up assessments utilizing validated questionnaires (OAB-q SF, IIQ7, UDI-6, PGI-I). Baseline functional status and technology comfort/use were assessed with a novel questionnaire. The primary outcome of test-phase success (>50% improvement in baseline symptoms) was compared based on presence of CI. Secondary outcomes included urinary questionnaire scores and device utilization. RESULTS: 92 patients were recruited, of which 88 underwent test-phase (60 PNE, 28 Stage 1). Mean age was 73±8 years and the majority were female (89%). Mean MoCA score was 23.7±4.1 (range 13 -30), and 63% met criteria for CI (MoCA <26). Patients with CI had lower baseline technology use and confidence. Patient reported measures of OAB symptom severity and impact were similar across the 2 groups. Overall test-phase success was 89% and did not differ based on CI (91% vs 87%, p=0.60). At a mean follow-up of 35±19 days, while patients with CI demonstrated lower rates of appropriate SNM controller use and amplitude changes, the reported symptom and impact outcomes did not differ. CONCLUSIONS: Older patients presenting for SNM testing for OAB have a high incidence of mild and moderate cognitive impairment, also associated with reduced comfort with technology. Test-phase success and short-term patient-reported outcomes after implant were not impacted by cognitive impairment, though long-term results are still unknown. Source of Funding: Investigator initiated Medtronic research grant © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1225 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Chen Shenhar More articles by this author Howard B. Goldman More articles by this author Jacquelyn Booher More articles by this author Lauren Gleich More articles by this author Omer Anis More articles by this author Tyler Trump More articles by this author Emily Emily More articles by this author Bradley Gill More articles by this author Jacqueline Zillioux More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,061 | 0,010 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».