Female Pelvic Med Reconstr Surg. 2021 Feb 1;27(2):69-71. doi: 10.1097/SPV.0000000000001008.
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.
膀胱过度活动症影响了相当一部分总人口，并对日常活动和生活质量产生了重大影响。膀胱过度活动症的一线治疗包括行为疗法，根据需要，这些疗法可能与药物治疗相结合。抗胆碱能药物和β-3 激动剂通常作为初始药物治疗，但在为虚弱或认知障碍的患者开抗胆碱能药物时应谨慎。最近，人们对长期使用抗胆碱能药物以及此类药物与认知障碍、痴呆和阿尔茨海默病的相关性风险产生了更多关注。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的增加之间存在显著关联，医生应就相关风险对患者进行咨询，开出最低有效剂量的药物，并考虑为有风险的患者开替代药物。
