Shiota Takako, Torimoto Kazumasa, Momose Hitoshi, Nakamuro Takuya, Mochizuki Hiroshi, Kumamoto Hiromi, Hirayama Akihide, Fujimoto Kiyohide
Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara-shi, Nara, Japan.
BMC Res Notes. 2014 Sep 25;7:672. doi: 10.1186/1756-0500-7-672.
Cognitive impairment is one of the side effects of using anticholinergic medicines for overactive bladder; however, its incidence has not been fully reported. We experienced two elderly Japanese patients with overactive bladder who had temporary cognitive impairment caused by anticholinergic medicines.
The first case was a 79-year-old female patient to whom imidafenacin (0.2 mg) was administered daily to control her frequent micturition and urgency. She was taking the following medicines: etizolam, triazolam, captopril, bisoprolol, and amlodipine besylate. Her Hasegawa dementia rating scale-revised was impaired from 26/30 to 17/30 and recovered to 25/30 after the imidafenacin treatment was stopped. The second case was an 82-year-old female patient to whom imidafenacin (0.2 mg) was administered daily for frequent micturition and urgency. She was taking the following medicines: losartan potassium and clenbuterol. Her Hasegawa dementia rating scale-revised decreased from 28/30 to 19/30 and recovered to 24/30 after the imidafenacin treatment was stopped. In our patients who were taking multiple medicines, there is a possibility that medicines other than anticholinergics may have caused cognitive impairment. We need to keep in mind that many elderly people take multiple medicines because of comorbidity.
Anticholinergic medicines can cause cognitive impairment in elderly people, and attention should be paid to cognition when elderly overactive bladder patients are treated with anticholinergic medicines.
认知障碍是使用抗胆碱能药物治疗膀胱过度活动症的副作用之一;然而,其发生率尚未得到充分报道。我们遇到了两名患有膀胱过度活动症的老年日本患者,他们因抗胆碱能药物出现了暂时性认知障碍。
首例患者为一名79岁女性,每天服用咪达那新(0.2毫克)以控制尿频和尿急。她正在服用以下药物:依替唑仑、三唑仑、卡托普利、比索洛尔和苯磺酸氨氯地平。她的修订版长谷川痴呆量表评分从26/30降至17/30,在停用咪达那新治疗后恢复到25/30。第二例患者为一名82岁女性,每天服用咪达那新(0.2毫克)治疗尿频和尿急。她正在服用以下药物:氯沙坦钾和克伦特罗。她的修订版长谷川痴呆量表评分从28/30降至19/30,在停用咪达那新治疗后恢复到24/30。在我们服用多种药物的患者中,除抗胆碱能药物外的其他药物有可能导致认知障碍。我们需要牢记,许多老年人因合并症而服用多种药物。
抗胆碱能药物可导致老年人认知障碍,在使用抗胆碱能药物治疗老年膀胱过度活动症患者时应注意认知情况。