Evaluation of Cognitive Function in Healthy Older Subjects Treated with Fesoterodine

Kay, Gary G.; Maruff, Paul; Scholfield, David; Malhotra, Bimal; Whelan, Laurence; Darekar, Amanda; Martire, Diane L.

doi:10.3810/pgm.2012.05.2543

Cited by 64 publications

(50 citation statements)

References 42 publications

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“…The study found no detectable impairment of cognition in a variety of cognitive measurements assessing reaction time, visual learning, executive function, and verbal learning and memory with either fesoterodine 4 or 8 mg compared with placebo. Alprazolam was associated with a significant reduction in performance on each test [67].…”

Section: Bladder Antimuscarinics and Cognitionmentioning

confidence: 97%

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

et al. 2015

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Urinary incontinence and lower urinary tract symptoms are highly prevalent in late life and are strongly associated with dementia and frailty. Incontinence is extremely common among those living in long-term care and is most commonly due to urgency incontinence. Although national and international guidelines for continence care exist, they often fail to consider the complex comorbidity found in patients with dementia and are often not followed; continence practices in long-term care may promote rather than prevent incontinence. The majority of those with dementia living in the community can be managed successfully with standard treatments, both pharmacological and non-pharmacological; the expectations and aims of treatment of both the patient and their caregivers should be considered. A dementia diagnosis does not preclude management of incontinence, but treatment options may be more limited in those with advanced dementia who are unable to retain information and modify behaviors. High-quality data to guide the choice of pharmacological agent in those with dementia are lacking. Oxybutynin has been shown to have significant adverse cognitive effects, but data to support the use of trospium, solifenacin, darifenacin, and fesoterodine are limited. No data are available for mirabegron. Neither age, frailty, nor dementia should be considered a barrier to pharmacological management, but consideration should be given to the total anticholinergic load. Evidence to guide the treatment of incontinence in this vulnerable patient group is scarce, and available guidelines adapted for each individual's situation should be applied.

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Section: Bladder Antimuscarinics and Cognitionmentioning

confidence: 97%

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

et al. 2015

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“…Although the individual may not report cognitive dysfunction related to antimuscarinics, it is reassuring that fesoterodine appeared to be largely cognitively safe in this population of community-dwelling older adults. A recent study showed no adverse effect of fesoterodine on memory or executive function in a group of cognitively intact older adults, 36 despite the high anticholinergic activity of the metabolite of fesoterodine: 5-hydroxymethyl tolterodine. 37 Unlike typical studies of antimuscarinics for OAB, this study included a large proportion of men (47%), which is consistent with epidemiological data on the prevalence of OAB.…”

Section: Discussionmentioning

confidence: 99%

Flexible‐Dose Fesoterodine in Elderly Adults with Overactive Bladder: Results of the Randomized, Double‐Blind, Placebo‐Controlled Study of Fesoterodine in an Aging Population Trial

Wagg

Khullar

Marschall-Kehrel³

et al. 2013

J American Geriatrics Society

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117

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“…The current patient is older and frailer than those included in the Kay's study. 6 Therefore, until further research can be done, fesoterodine should be used with caution in those who might have a risk of increased drug exposure (such as renal impairment) or in those with a diminished cognitive reserve, notably the elderly and frail population.…”

Section: Discussionmentioning

confidence: 99%

“…Its effect on attention, memory, and executive function was similar to placebo in a double-blind, double-dummy, crossover study on 20 healthy elderly patients aged between 65 and 84 years old. 6 In a double-blind clinical trial involving 562 vulnerable elderly patients, no deterioration of mini-mental state examination (MMSE) score was observed; however, two subjects reported subjective impairment after an increase to fesoterodine 8 mg dose. 7 In another trial, three patients discontinued treatment due to an acute confusional state, but the site investigator judged it unrelated to fesoterodine.…”

Section: Introductionmentioning

confidence: 99%

Delirium following fesoterodine treatment for urgency incontinence in an 89-year old man

Charbonneau¹,

Bisset²,

Nguyen

2016

CUAJ

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We describe the case of an 89-year-old man who developed delirium following the introduction of fesoterodine to treat his urgency incontinence. The patient started experiencing visual hallucinations approximately five days after starting fesoterodine 4 mg once daily. Delirium resolved after fesoterodine was stopped. Despite the apparent safe cognitive profile due to its pharmacodynamic properties, fesoterodine should be used with caution in the elderly, frail population.

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Evaluation of Cognitive Function in Healthy Older Subjects Treated with Fesoterodine

Cited by 64 publications

References 42 publications

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

Flexible‐Dose Fesoterodine in Elderly Adults with Overactive Bladder: Results of the Randomized, Double‐Blind, Placebo‐Controlled Study of Fesoterodine in an Aging Population Trial

Delirium following fesoterodine treatment for urgency incontinence in an 89-year old man

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