Effect of Anticholinergic Use for the Treatment of Overactive Bladder on Cognitive Function in Postmenopausal Women

Geller, Elizabeth J.; Crane, Andrea K.; Wells, Ellen C.; Robinson, Barbara L.; Jannelli, Mary L.; Khandelwa, Christine M.; Connolly, Anna Marie; Parnell, Brent A.; Matthews, Catherine A.; Dumond, Julie B.; Busby‐Whitehead, Jan

doi:10.1007/bf03261923

Cited by 23 publications

(5 citation statements)

References 30 publications

(39 reference statements)

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“…For instance, alpha-adrenoceptor antagonists induce vasodilatation and subsequently lower blood pressure, with potential symptoms including asthenia, dizziness, fatigue, and orthostatic hypotension, particularly upon treatment initiation [41–43]. Similarly, urinary antispasmodics have a high potential of producing anticholinergic effects, which can result in cognitive side effects including memory changes, blurred vision, somnolence, hallucinations, confusion, and delirium [44,45]. …”

Section: Discussionmentioning

confidence: 99%

Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study

et al. 2017

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BackgroundWhile some medicinal drugs have been found to affect driving ability, no study has investigated whether a relationship exists between these medicines and crashes involving pedestrians. The aim of this study was to explore the association between the use of medicinal drugs and the risk of being involved in a road traffic crash as a pedestrian.Methods and findingsData from 3 French nationwide databases were matched. We used the case-crossover design to control for time-invariant factors by using each case as its own control. To perform multivariable analysis and limit false-positive results, we implemented a bootstrap version of Lasso. To avoid the effect of unmeasured time-varying factors, we varied the length of the washout period from 30 to 119 days before the crash. The matching procedure led to the inclusion of 16,458 pedestrians involved in an injurious road traffic crash from 1 July 2005 to 31 December 2011. We found 48 medicine classes with a positive association with the risk of crash, with median odds ratios ranging from 1.12 to 2.98. Among these, benzodiazepines and benzodiazepine-related drugs, antihistamines, and anti-inflammatory and antirheumatic drugs were among the 10 medicines most consumed by the 16,458 pedestrians. Study limitations included slight overrepresentation of pedestrians injured in more severe crashes, lack of information about self-medication and the use of over-the-counter drugs, and lack of data on amount of walking.ConclusionsTherapeutic classes already identified as impacting the ability to drive, such as benzodiazepines and antihistamines, are also associated with an increased risk of pedestrians being involved in a road traffic crash. This study on pedestrians highlights the necessity of improving awareness of the effect of these medicines on this category of road user.

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Section: Discussionmentioning

confidence: 99%

Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study

et al. 2017

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“…Thirty-three studies were conducted in community dwellings and 14 studies in hospital settings, one study was conducted across both settings [20]. Participants in the hospital settings were admitted for a variety of medical reasons including cancer [21], general frailty/long-term care [22] and acute bladder symptoms [23,24]. Supplementary Table 1 illustrates the estimates of anti-cholinergic load or burden to estimate the ACB in each included study.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Thirty-three studies reported the impact of medications with anti-cholinergic properties on cognitive function [5][6][7][17][18][19][23][24][25][26][27][28][29][30][31][32]37,38,[41][42][43][44][45]48,[49][50][51][52][54][55][56][57][58]. This was evaluated with a number of tools, most commonly the MMSE.…”

Section: Anti-cholinergic Effect On Cognitive Functionmentioning

confidence: 99%

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Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review

et al. 2014

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“…4,16,[37][38][39][40][41][42][43][44][45][50][51][52][53] A prospective cohort study reported a 12-week overall discontinuation rate for anticholinergics of 57.1%. 54 In a retrospective cohort study, 91.7% of patients failed to achieve treatment goals with their index anticholinergic over 24 months and 51.9% did not demonstrate appropriate adherence (medication possession ratio ≥80%). 55 Other studies reported 12-month persistence with rates ranging from 13.8% to 40.2%.…”

Section: Anticholinergic Medicationsmentioning

confidence: 99%

Diagnosis and management of overactive bladder: A review

Νitti

Patel

Karram

2021

J of Obstet and Gynaecol

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Aim Overactive bladder (OAB) is a common and troublesome condition that can significantly impair quality of life. This review aims to educate providers of obstetrics and gynecology services about available therapies for OAB and what to expect following treatment. Methods Here, we review published data from studies that have evaluated available treatments for OAB. Relevant articles published over the past 2 decades, including large multicenter trials, were identified through a literature search using http://pubmed.gov, and the references in those articles were also manually searched to find additional articles. Treatment guidelines and product labels were also reviewed. Results Behavioral therapy is recommended as a first choice for OAB management; pharmacologic treatment (anticholinergics, β3‐adrenoceptor agonists) as second‐line treatment; and onabotulinumtoxinA, peripheral tibial nerve stimulation, and sacral nerve stimulation as third‐line therapy for patients refractory or intolerant to first‐ and second‐line treatments. A stepwise approach to treatment through first‐, second‐, and third‐line therapies is recommended, recognizing this may not be appropriate for all patients. Conclusions To optimize symptom control and set realistic expectations, patients should be carefully monitored and counseled appropriately on available treatment options.

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Effect of Anticholinergic Use for the Treatment of Overactive Bladder on Cognitive Function in Postmenopausal Women

Abstract: Background-Overactive bladder (OAB) is a common condition affecting the elderly. The mainstay of treatment for OAB is medical therapy with anticholinergics. However, adverse events have been reported with this class of drugs including cognitive changes.

Cited by 23 publications

References 30 publications

Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study

Prescription medicine use by pedestrians and the risk of injurious road traffic crashes: A case-crossover study

Effect of medications with anti-cholinergic properties on cognitive function, delirium, physical function and mortality: a systematic review

Diagnosis and management of overactive bladder: A review

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