OBJECTIVE: Overactive Bladder (OAB) syndrome is defined symptomatically and is suggestive of detrusor overactivity. Detrusor overactivity can occur due to an underlying neurological disease (neurogenic detrusor overactivity). Early identification of neurogenic detrusor overactivity may facilitate more effective management. The objective of our study was to explore the likely indicators supporting a neurogenic cause for detrusor overactivity within an OAB population, providing a clearer case for proactive investigation of bladder problems. METHODS: The DIN–LINK database was used to conduct a 1–year retrospective cohort analysis of patients across Great Britain with OAB and neurological disease. Patients who had an OAB symptom(s) and/or a prescription for an OAB–related therapy during the study period (September 2003 — August 2004) were included in this analysis and constituted the OAB cohort. All the records of those within the cohort were analysed to identify whether the patient was diagnosed or receiving treatment for Parkinson's disease, stroke, multiple sclerosis or spinal cord injury. Data was analysed by age, gender and OAB symptoms. RESULTS: The cohort contained 13,482 OAB patients, representing a prevalence of 1.7% of the population (n=815,054) of whom 61% (n=8,150) were women and 43% were aged over 65. In total, 1314 (10%) patients had a neurological disease, this increased to 16% (948 patients) in those over 65. Incontinence was experienced by 29% (n=384) of those with a neurological disease but in only 18% of the complete cohort. Those with neurological disease also more commonly experienced urinary frequency. CONCLUSION: This study suggests that there is value in assessing patients who present with OAB symptoms for early signs of underlying neurological conditions. It is important to identify neurological disease as the cause of detrusor overactivity. This will help clinicians understand the aetiological factors behind the condition and also help in its overall management.