Ninjin'yoeito in the Management of Frailty and Overactive Bladder in Elderly Women: A Report of Two Cases

This case report examines the efficacy of Ninjin'yoeito (NYT), a traditional Japanese Kampo medicine, in managing frailty and overactive bladder (OAB) in two elderly female patients. We present two cases: an 84-year-old woman and an 80-year-old woman, both experiencing decreased physical strength, OAB, insomnia, and anxiety. The 80-year-old patient also exhibited cognitive decline. After three months of NYT treatment (7.5 g/day, Kracie Pharma Ltd., Tokyo, Japan), both patients showed significant improvements. The 84-year-old patient's frailty status improved from frail to pre-frail, with enhancements in grip strength (16 kg to 18 kg), urinary symptoms, and Short Form-36 scores. Her total testosterone levels increased from 14 ng/mL to 28 ng/mL. The 80-year-old patient demonstrated marked improvements in cognitive function (Mini-Mental State Examination score increased from 12 to 23), physical activity, and OAB symptoms. Her grip strength increased from 12 kg to 18 kg, and total testosterone levels rose from 20 ng/mL to 38 ng/mL. Both patients experienced reductions in urinary frequency and nocturia. The 84-year-old patient's Overactive Bladder Symptom Score (OABSS) improved, particularly in urgency and urgency incontinence. The 80-year-old patient's OABSS showed significant improvements across all components. Sleep quality, assessed by the Pittsburgh Sleep Quality Index, improved for both patients. These cases suggest that NYT may be an effective and well-tolerated treatment option for elderly patients with concurrent frailty and OAB, potentially addressing multiple geriatric issues simultaneously. The observed increases in testosterone levels may contribute to the overall improvements. Further investigation in larger clinical studies is warranted.