Urinary Dysfunction in ALS Patients: Assessment With the Overactive Bladder Awareness Tool

AIMS: To compare urinary symptom bother and overactive bladder screening positivity between patients with amyotrophic lateral sclerosis (ALS) and controls using the Overactive Bladder Awareness Tool (OAB-V8). METHODS: This retrospective study included 101 patients with definite ALS and 324 controls. OAB-V8 scores were compared using Welch's t-test and multiple linear regression adjusted for age and sex with HC3 robust standard errors. Screening positivity (OAB-V8 ≥ 8) was evaluated using Firth's logistic regression adjusted for age and sex. RESULTS: Mean OAB-V8 scores were 14.0 ± 6.8 in ALS patients and 12.40 ± 5.10 in controls (unadjusted p = 0.026). The adjusted mean difference was 1.65 points (95% confidence interval [CI] 0.20-3.10; p = 0.026). Screening positivity was observed in 101/101 ALS patients (100%) and 272/324 controls (84.0%). The adjusted odds ratio was 41.03 (95% penalized profile-likelihood CI 5.75-5205.66; p < 0.001), indicating substantial uncertainty in its magnitude. CONCLUSIONS: ALS patients reported modestly greater urinary symptom burden than controls after adjustment for age and sex. These findings support clinical attention to urinary symptoms in ALS but do not establish their underlying urodynamic mechanism.