Tools
Tools
Richardson, Kathryn 
ORCID: https://orcid.org/0000-0002-0741-8413
(2021)
The cognitive effect of anticholinergics for patients with overactive bladder.
Nature Reviews Urology, 18 (11).
686–700.
ISSN 1759-4812
Preview |
PDF (Accepted_Manuscript)
- Accepted Version
Download (504kB) | Preview |
Abstract
Overactive bladder (OAB) is often treated with medications that block the cholinergic receptors in the bladder (known as anticholinergics). The effect of this medication class on cognition and risk of dementia has been increasingly studied over the past 40 years after initial studies suggested that the anticholinergic medication class could affect memory. Short-term randomized clinical trials demonstrated that the administration of the anticholinergic oxybutynin leads to impaired memory and attention, and large, population-based studies showed associations between several different anticholinergic medications and dementia. However, trials involving anticholinergics other than oxybutynin have not shown such substantial effects on short-term cognitive function. This discordance in results between short-term cognitive safety of OAB anticholinergics and the long-term increased dementia risk could be explained by the high proportion of patients using oxybutynin in the OAB subgroups of the dementia studies, or a study duration that was too short in the prospective clinical trials on cognition with other OAB anticholinergics. Notably, all studies must be interpreted in the context of potential confounding factors, such as when prodromal urinary symptoms associated with the early stages of dementia lead to an increase in OAB medication use, rather than the use of OAB medication causing dementia. In patients with potential risk factors for cognitive impairment, the cautious use of selected OAB anticholinergic agents with favourable physicochemical and pharmacokinetic properties and clinical trial evidence of cognitive safety might be appropriate.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding Information: J.N.P. is supported in part by funding from the United Kingdom’s Department of Health NIHR Biomedical Research Centres funding scheme. K.R. is supported by funding from the United Kingdom’s Alzheimer’s Society. |
| Uncontrolled Keywords: | urology ,/dk/atira/pure/subjectarea/asjc/2700/2748 |
| 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 |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 31 Mar 2022 15:30 |
| Last Modified: | 21 Apr 2023 01:29 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/84410 |
| DOI: | 10.1038/s41585-021-00504-x |
Downloads
Downloads per month over past year
Actions (login required)
 |
View Item |