Female Pelvic Med Reconstr Surg. 2017 May/Jun;23(3):177-178. doi: 10.1097/SPV.0000000000000423.
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.
膀胱过度活动症影响着相当一部分总人口,对日常活动和生活质量有重大影响。在考虑治疗时,应首先采用行为疗法,其次是药物疗法。抗胆碱能药物和β-3激动剂常被用作初始药物治疗,但在为体弱或认知受损患者开抗胆碱能药物时应谨慎。最近,人们对普通人群中抗胆碱能药物及其相关的认知障碍、痴呆和阿尔茨海默病风险产生了担忧。鉴于现有证据表明抗胆碱能药物的使用与认知障碍和痴呆风险增加之间存在显著关联,医疗服务提供者应就相关风险提供咨询,开出最低有效剂量,并为有风险的患者考虑替代药物。