Cognitive changes in women starting anticholinergic medications for overactive bladder: a prospective study.

To assess cognitive changes in women 12 months after starting anticholinergic medications for overactive bladder syndrome (OAB).

We present a prospective cohort study assessing changes in cognition in women seen in a referral urogynecology practice. We compared women who started anticholinergic OAB medications with women not on anticholinergic OAB medications. The primary outcome was change over time on the Montreal Cognitive Assessment (MOCA) screening score. At enrollment, women completed a baseline MOCA screening, a Geriatric Depression Screen (GDS), and an assessment of medications to create an anticholinergic burden score (ACB). At 3, 6, 9, and 12 months after enrollment women were administered the MOCA, GDS, and a review of their medications and medical problems. Statistical analysis was performed using a linear mixed effects model taking into account correlated error terms given multiple MOCA assessments at various time points per patient.

A total of 106 women were enrolled, 60 in the OAB medication group and 46 in the control (non-OAB medication) group. The mean age was 77 years, 93% of women were Caucasian, and 98% completed high school, with no difference between groups. Over time there was no difference in change of MOCA score between the OAB and control groups when controlling for age, GDS score, and ACB score (p = 0.78). This association did not change when women with a neurological diagnosis were excluded (n = 6). On average MOCA scores for the OAB group increased by 0.76 over 12 months and the control group increased 0.39, with no difference between the groups (p = 0.53).

We found no changes in MOCA scores between OAB medication and control groups after controlling for age, depression, and polypharmacy after 12 months of follow-up.

International urogynecology journal. 2019 Dec 07 [Epub ahead of print]

Shilpa Iyer, Svjetlana Lozo, Carolyn Botros, Chi Wang, Alexandra Warren, Peter Sand, Janet Tomezsko, Sylvia Botros, Adam Gafni-Kane, Karen Sasso, Roger P Goldberg

Department of Obstetrics and Gynecology, Section of Female Pelvic Medicine and Reconstructive Surgery, The University of Chicago, 5841 South Maryland Avenue, MC 2050, Chicago, IL, 60637-1470, USA. ., Department of Obstetrics and Gynecology, Section of Urogynecology, NorthShore University Health Systems, Affiliated with The University of Chicago, Skokie, IL, USA., Lehigh Valley Health Network, Allentown, PA, USA., Research Institute, NorthShore University Health Systems, Evanston, IL, USA., Central Michigan University College of Medicine, Mount Pleasant, MI, USA., Womens' Health Institute of Illinois, Oak Lawn, IL, USA., Department of Urology, The University of Texas at San Antonio, San Antonio, TX, USA.