Randomized, Placebo‐Controlled Trial of the Cognitive Effect, Safety, and Tolerability of Oral Extended‐Release Oxybutynin in Cognitively Impaired Nursing Home Residents with Urge Urinary Incontinence

Abstract

Short-term treatment using oral extended-release oxybutynin 5 mg once daily was safe and well tolerated, with no delirium, in older female nursing home participants with mild to severe dementia. Future research should investigate different dosages and long-term treatment.

Oxybutynin extended release for the management of overactive bladder: a clinical review

“…Study limitations include the short duration, homogenous Caucasian female population as well as lack of information about efficacy at this dosage. 32 However, these results do contradict the guidelines of the American Neurological Association, the American Psychiatric Association and the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults 33 and conclusions about their use in this population remain guarded.…”

Flexible‐Dose Fesoterodine in Elderly Adults with Overactive Bladder: Results of the Randomized, Double‐Blind, Placebo‐Controlled Study of Fesoterodine in an Aging Population Trial

“…The efficacy and safety profiles of fesoterodine in the SOFIA trial support the favorable benefit:risk ratio of antimuscarinic drugs in older adults with OAB reported in previous trials. [14][15][16][17] In addition, the study provides valuable data for individuals older than 75, indicating that fesoterodine is effective and well tolerated in this elderly subgroup. These results in this subgroup support those of the post hoc analysis of data from two randomized, fixeddose, placebo-controlled studies that indicated that the 4-and 8-mg doses of fesoterodine effectively treated OAB symptoms in individuals younger than 75, with the 8-mg dose being most effective in those aged 75 and older.…”

Effect of Anticholinergic Use for the Treatment of Overactive Bladder on Cognitive Function in Postmenopausal Women

“…Our repeated testing likely led to these improved cognitive scores due to a learning effect, which has been reported previously. [14] While the HVLT-R offers a different set of 12 words with each administration, the OMC and Mini-Cog have repetitive elements. Frequent administration of all three tests may have been an intervention in itself, by providing memory exercises for the subjects.…”

“…[9,10,12] It is therefore not surprising that anticholinergic medications have been linked to cognitive impairment. [13,14] Multiple cognitive effects have been reported with anticholinergic use: memory changes, blurred vision, somnolence, hallucinations, confusion, and delirium. All of these cognitive impairments are more prevalent in the elderly, possibly due to the increased CNS absorption of anticholinergics in this population.…”