Clinical Consensus Statement: Association of Anticholinergic Medication Use and Cognition in Women With Overactive Bladder
Colored text reflects updated information from the original 2017 publication (doi: 10.1097/SPV.0000000000000423) This document was originally developed by the American Urogynecologic Society (AUGS) Guidelines Committee with the assistance of Tonya N. Thomas, MD, and Mark D. Walters, MD. This document was updated by the Publications Committee, September 2020.
Abstract
ABSTRACT: Overactive bladder affects a significant portion of the overall population and has substantial impact on daily activities and quality of life. First-line treatment of overactive bladder includes behavioral therapies, which may be combined with pharmacologic management as indicated. Anticholinergic medications and β-3 agonists are often used as initial pharmacologic therapy, but caution should be taken in prescribing anticholinergic medications in frail or cognitively impaired patients. Recently, additional concerns have emerged regarding prolonged use of anticholinergic medications and the associated risk of cognitive impairment, dementia, and Alzheimer disease in the general population. Given the available evidence, which has shown significant associations between anticholinergic medication use and increased risk of cognitive impairment and dementia, providers should counsel on the associated risks, prescribe the lowest effective dose, and consider alternative medications in patients at risk.