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ToolsRichardson, Kathryn, Petersen, Irene, Mattishent, Katharina, Enwo, Oby Otu, Steel, Nick, Edwards, Duncan, Panicker, Jalesh N., Irving, Stuart, Fox, Christopher, Robinson, Louise and Loke, Yoon Kong (2025) Overactive bladder medications and risk of emergency hospital admissions with delirium in adults without dementia: Self-controlled case series. Age and Ageing, 54 (10). ISSN 0002-0729
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Abstract
Aims: We examined whether anticholinergic overactive bladder (OAB) medications are associated with emergency hospital admissions with delirium in adults without dementia. Setting: England’s primary care linked to inpatient records. Methods: The source population comprised 215 293 adults initiating anticholinergic OAB medications (e.g. oxybutynin, solifenacin and tolterodine) during July 2010–December 2019 when aged ≥50 years, without dementia, severe mental illness or <12 months registration. We conducted self-controlled case-series including 1831 men and 1954 women with emergency hospital admissions with delirium. Incidence rate ratios (IRR) were estimated in risk periods during 6 months before and 12 months after initiating OAB medications, adjusted for time-varying age, separately in men and women. Results: The risk of delirium admissions was elevated for the first 1–30 days of prescriptions [IRR 1.54 (95% CI 1.30–1.82) for men, 1.44 (1.22–1.70) for women] and whilst reducing over time for women [1.10 (0.94–1.29) for 91–365 days of prescriptions], it remained elevated for men [1.38 (1.17–1.64)]. There was some evidence of greater delirium IRRs in older men and men initiating higher dosages. In secondary analysis of 502 adults initiating mirabegron (non-anticholinergic beta-3 receptor agonist), the delirium IRRs during the first 1–30 and 31–90 days of prescriptions were 1.15 (0.76–1.75) and 0.72 (0.47–1.09). Conclusion: We observed increased hospital admission rates with delirium for adults without dementia whilst prescribed OAB anticholinergics, but not whilst prescribed mirabegron. Delirium risk remained raised for longer for men and was greater in older men. Alternative management options for OAB in older people should be considered before prescribing anticholinergic medications.
| Item Type: | Article |
|---|---|
| Additional Information: | Data Availability: Data from the Clinical Practice Research Datalink cannot be shared by the authors but is available directly from CPRD. Full code lists corresponding to the exposures and each of the covariates we included are available on request. This study is based in part on data from the Clinical Practice Research Datalink obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. The data is provided by patients and collected by the NHS as part of their care and support. The interpretation and conclusions contained in this study are those of the authors alone. Hospital Episode Statistics Admitted Patient Care data Copyright © (2021), was re-used with the permission of The Health & Social Care Information Centre. All rights reserved. Funding: This work was supported by funding from the Alzheimer’s Society (AS-JF-2018-454). The funders had no role is the design of the study or the interpretation of the findings. |
| Uncontrolled Keywords: | anticholinergic,antimuscarinic,dementia,medication use,older people,overactive bladder,pharmacoepidemiology,self-controlled case series,ageing,geriatrics and gerontology,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/1300/1302 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Health Promotion Faculty of Medicine and Health Sciences > Research Centres > Public Health Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care |
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| Depositing User: | LivePure Connector |
| Date Deposited: | 14 Nov 2025 17:30 |
| Last Modified: | 19 Nov 2025 15:32 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/101005 |
| DOI: | 10.1093/ageing/afaf308 |
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