Mesh : Adrenergic beta-3 Receptor Antagonists / administration & dosage Aged Cholinergic Antagonists / administration & dosage adverse effects Cognitive Dysfunction / chemically induced prevention & control Consensus Dementia / chemically induced prevention & control Female Humans Quality of Life Risk Factors Urinary Bladder, Overactive / drug therapy

来  源:   DOI:10.1097/SPV.0000000000000423

Abstract:
Overactive bladder affects a significant portion of the overall population and has substantial impact on daily activities and quality-of-life. When considering treatment, behavioral therapies should be instituted first, followed by medical therapies. Anticholinergic medications and beta-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, concerns have developed regarding 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.
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