Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Jun 1;32(6):652-659.
doi: 10.1097/SPV.0000000000001708.

Antimuscarinic Use and Dementia Incidence in Women With Overactive Bladder

Caitlyn E Painter  1 , Douglas Stram  2 , Victor S Velasco  2   3 , Wenjin Cheng  2 , Abner Korn  1 , Olga Ramm  1
Affiliations

Antimuscarinic Use and Dementia Incidence in Women With Overactive Bladder

Caitlyn E Painter et al. Urogynecology (Phila). .

Abstract

Importance: Antimuscarinic medications are widely used for overactive bladder (OAB). Recent studies linking antimuscarinics to dementia and cognitive impairment (DCI) have raised concerns about long-term antimuscarinic use for OAB management.

Objectives: We sought to investigate the incidence of DCI among patients with OAB and whether DCI incidence is associated with antimuscarinic use.

Study design: We conducted a retrospective cohort study of women aged 55 years or older with OAB, without a preexisting DCI diagnosis, within a managed health care system with at least 10 years of follow-up. Participants were divided into 2 groups: antimuscarinic users and nonusers for OAB. We calculated each participant's total antimuscarinic burden and identified incident DCI using International Classification of Diseases codes. We used bivariate analysis to identify factors associated with DCI and multivariate logistic regression to assess the association between antimuscarinic use and DCI.

Results: Of the 16,249 women included, 7,141 (44%) received antimuscarinics for OAB and 1,200 (7.4%) were diagnosed with DCI. Compared with those without DCI, women with DCI were older, less likely to be white, had more comorbidities, were more likely to use antimuscarinics, and had higher mean anticholinergic burden scores. Age at OAB diagnosis (OR: 1.13, CI: 1.12-1.14, P <0.001), diabetes (OR: 1.43, CI: 1.22-1.68, P <0.001), and bladder antimuscarinic use (OR: 1.27, CI: 1.12-1.44, P <0.001) were associated with incident DCI using multivariate analysis.

Conclusions: Among women with OAB, DCI is associated with bladder antimuscarinic use and with higher cumulative exposure to antimuscarinics. This association persists after controlling for age and comorbidities.

PubMed Disclaimer

Conflict of interest statement

The authors have declared they have no conflicts of interest.

References

    1. Reynolds WS, Fowke J, Dmochowski R. The burden of overactive bladder on US public health. Curr Bladder Dysfunct Rep. 2016;11(1):8–13. doi:10.1007/s11884-016-0344-9 - DOI
    1. Milsom I, Coyne KS, Nicholson S, et al. Global prevalence and economic burden of urgency urinary incontinence: a systematic review. Eur Urol. 2014;65(1):79–95. doi:10.1016/j.eururo.2013.08.031 - DOI
    1. Powell LC, Szabo SM, Walker D, et al. The economic burden of overactive bladder in the United States: a systematic literature review. Neurourol Urodyn. 2018;37(4):1241–1249. doi:10.1002/nau.23477 - DOI
    1. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327–336. doi:10.1007/s00345-002-0301-4 - DOI
    1. Andersson KE. Antimuscarinics for overactive bladder. Lancet Neurol. 2004;3(1):46–53. doi:10.1016/s1474-4422(03)00622-7 - DOI

Substances

LinkOut - more resources