Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan, ROC.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, ROC.
Sci Rep. 2021 Mar 1;11(1):4827. doi: 10.1038/s41598-021-84229-2.
The association between bladder antimuscarinic use and dementia development is unclear. We used data from the Taiwan National Health Insurance Research Database to determine the association between the exposure dose and duration of bladder antimuscarinics and the subsequent dementia risk. We enrolled participants aged 55 years or more and defined a dementia cohort (International Classification of Diseases, Ninth Revision, Clinical Modification codes 290, 294.1, and 331.0). We used a propensity score matching method, and randomly enrolled two controls without dementia. We evaluated dementia risk with respect to the exposure dose and duration of treatment with seven bladder antimuscarinics (oxybutynin, propiverine, tolterodine, solifenacin, trospium, darifenacin, and fesoterodine) used for at least 1 year before the index date, after adjusting for age, sex, comorbidities, and medications. The dementia risk was 2.46-fold (95% confidence interval: 2.22-2.73) higher in Taiwanese patients who used bladder antimuscarinics for ≥ 1 year than in those who were not exposed to this treatment. The risk proportionally increased with increasing doses of antimuscarinics for less than 4 years. Taiwanese patients aged 55 years or more on bladder antimuscarinics exhibited a higher risk of dementia. Additional studies in other countries are required to determine whether this result is valid worldwide.
膀胱抗毒蕈碱药物的使用与痴呆发展之间的关联尚不清楚。我们使用来自台湾全民健康保险研究数据库的数据，确定膀胱抗毒蕈碱药物暴露剂量和持续时间与随后的痴呆风险之间的关联。我们纳入了年龄在 55 岁及以上的参与者，并定义了一个痴呆队列（国际疾病分类，第九修订版，临床修正码 290、294.1 和 331.0）。我们使用倾向评分匹配方法，随机纳入两名没有痴呆的对照组参与者。我们评估了暴露于至少 1 年之前的索引日期后，使用七种膀胱抗毒蕈碱药物（奥昔布宁、丙哌维林、托特罗定、索利那新、曲司氯铵、达非那新和非索罗定）治疗 1 年以上的患者的痴呆风险，同时调整了年龄、性别、合并症和药物使用情况。与未接受这种治疗的患者相比，在台湾患者中，使用膀胱抗毒蕈碱药物治疗至少 1 年的患者的痴呆风险高 2.46 倍（95%置信区间：2.22-2.73）。抗毒蕈碱药物剂量较低且使用时间不到 4 年的患者，风险呈比例增加。年龄在 55 岁及以上的台湾膀胱抗毒蕈碱药物使用者痴呆风险更高。需要在其他国家进行更多研究，以确定这一结果是否在全球范围内有效。
