Researchers of this nested case-control study examined the link between anticholinergic drugs for overactive bladder (OAB) and dementia risk in older adults in England. Among 170,742 patients aged 55 and older with dementia, matched with 804,385 controls, cumulative drug use over 3 to 16 years revealed an 18% increased dementia risk with anticholinergic OAB treatments (adjusted odds ratio 1.18). Specific drugs like oxybutynin (up to 31% increased risk), solifenacin (up to 29%), and tolterodine (up to 27%) showed the highest associations, while others, such as darifenacin and trospium chloride, showed no significant risk. The non-anticholinergic drug mirabegron showed variable associations, possibly tied to prior anticholinergic use.

The findings emphasize the importance of weighing dementia risks when prescribing OAB treatments for older adults. Clinicians are advised to consider alternatives with lower dementia risk profiles, such as mirabegron, when appropriate. This study highlights the need for personalized treatment strategies that balance symptom management with long-term cognitive health.

Reference: Iyen B, Coupland C, Bell BG, et al. Risk of dementia associated with anticholinergic drugs for overactive bladder in adults aged ≥55 years: nested case-control study. BMJ Med. 2024;3(1):e000799. doi: 10.1136/bmjmed-2023-000799.