Anticholinergic medication increases the risk of dementia in patients with overactive bladder

This study investigated whether medication for overactive bladder (OAB) is associated with dementia. Researchers suggested that the use of anticholinergic medication might increase the risk of dementia compared to beta-3 agonist users.

OAB consists of a frequent and sudden urge to urinate that is difficult to control. It is present in 10 to 15% of the population. The first-line treatment was anticholinergic medications. This medication stops the nerve impulses responsible for internal muscle movement. However, recent studies suggested that it might also play a role in developing dementia.

Dementia consists in the loss of memory, language, and thinking ability. It is a severe disease that affects daily life. However, these studies have contradictory results and a small number of participants.

Beta-3 agonists are muscle relaxers also used to treat OAB. Prior studies comparing this drug to anticholinergic drugs showed that they have similar effectiveness. Therefore, both have been recommended for OAB first-line treatment. However, it is not clear yet if beta-3 agonists also play a role in dementia.

This study included information about patients with overactive bladder. 47,324 were anticholinergic drug users (group 1) such as tolterodine (Detrol), oxybutynin (Ditropan), and solifenacin (Vesicare) and 23,662 beta-3 agonists users (group 2) such as mirabegron (Myrbetriq). The average prescription duration in group 1 was 30 days and in group 2 was 64 days.

Group 1 had an increased risk of dementia. These patients were at 1.23 times more at risk of having dementia when compared to group 2. Of all users, males and those aged 75 years or less on anticholinergic medication had the highest risk of having dementia.

This study concluded that OAB anticholinergic medication increases the risk of dementia when compared to beta-3 agonists.  

This study accounted for filled prescriptions only. The actual adherence to treatment was not assessed.

If you have concerns regarding OAB treatment, please discuss this with your doctor.