Overactive bladder (OAB) is a side effect of cholinesterase inhibitor (ChEI) medicines used to treat dementia and Alzheimer’s disease, according to a study from the University of Houston College of Pharmacy published in the Journal of the American Geriatrics Society. The study’s initial author, Prajakta Masurkar, based the research on her dissertation.
Overactive bladder, commonly known as OAB, is characterized by a strong desire to urinate that is difficult to control. Dementia is a set of symptoms that are linked to a loss of memory, reasoning, or other cognitive abilities.
Alzheimer’s disease, which accounts for 60 percent to 80 percent of dementia cases, is the most frequent cause. Donepezil, galantamine, and rivastigmine are examples of ChEI medicines that improve communication between nerve cells and hence improve cognition.
“The study found that the risk of overactive bladder varies across individual ChEIs,” reports Rajender R. Aparasu, Mustafa, and Sanober Lokhandwala Endowed Professor of Pharmacy and chair, Department of Pharmaceutical Health Outcomes and Policy.
“Using a national cohort of older adults with dementia, we also found that donepezil was associated with a 13% increased risk of OAB compared to rivastigmine, whereas there was no differential risk of OAB with galantamine and rivastigmine.”
The study found that the risk of overactive bladder varies across individual ChEIs. Using a national cohort of older adults with dementia, we also found that donepezil was associated with a 13% increased risk of OAB compared to rivastigmine, whereas there was no differential risk of OAB with galantamine and rivastigmine.
Rajender R. Aparasu, Mustafa, and Sanober Lokhandwala
Dementia is a generic word for a loss of capacity to recall, think, or make judgments that interfere with daily tasks. The most frequent form of dementia is Alzheimer’s disease.
Dementia is not a normal aspect of aging, even though it usually affects older people. The study looked at 524,975 dementia patients (aged 65 and up) who used ChEIs using Medicare data (donepezil 80.72 percent, rivastigmine 16.41 percent, galantamine 2.87 percent ).
Within six months of starting ChEI, the major outcome of interest was OAB diagnosis or prescription of antimuscarinics, which assist correct overactive bladder.
While considerable research has been done on the effects of all ChEIs and antimuscarinic use, there have been few investigations on the impact of specific ChEIs on the risk of OAB.
Previous research has linked the usage of ChEIs to an increased chance of receiving an antimuscarinic medication. This research opens up a new avenue.
“The findings suggest the need to understand and manage medication-related morbidity in older adults with dementia,” said Aparasu.
