Cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study
Abstract Background Studies have shown an association between lower urinary tract symptoms (LUTS) and an increased risk of dementia. Whether anticholinergic use contributes to the development of dementia in patients with LUTS remains unknown, especially in Asian populations. This study aims to inves...
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doaj-c2582ffd6470417583653ffacfaec49b2021-01-03T12:05:38ZengBMCBMC Geriatrics1471-23182019-12-011911910.1186/s12877-019-1401-yCumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort studyYi-Chi Wang0Yung-Liang Chen1Chun-Che Huang2Chung-Han Ho3Yu-Tung Huang4Ming-Ping Wu5Ming-Jung Ou6Chiu-Hsien Yang7Ping-Jen Chen8Department of Family Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical UniversityDepartment of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical UniversityDepartment of Healthcare Administration, College of Medicine, I-Shou UniversityDepartment of Medical Research, Chi-Mei Medical CenterCenter for Big Data Analytics and Statics, Chang Gung Memorial HospitalDivision of Urogynecology, Department of Obstetrics and Gynecology, Chi Mei Foundation HospitalDepartment of Family Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical UniversityDepartment of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityDepartment of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityAbstract Background Studies have shown an association between lower urinary tract symptoms (LUTS) and an increased risk of dementia. Whether anticholinergic use contributes to the development of dementia in patients with LUTS remains unknown, especially in Asian populations. This study aims to investigate the association between anticholinergic use and dementia in patients with LUTS. Methods This study included patients aged 50 years and over with newly diagnosed LUTS (January 2001 to December 2005), divided into four groups according to their cumulative defined daily doses (cDDDs) of anticholinergics: < 28 cDDDs, 28–84 cDDDs, 85–336 cDDDs, ≥337 cDDDs. Patients were followed up until dementia developed or until the end of 2012. Results We recruited a total of 16,412 patients. The incidence of dementia was 10% in the < 28 cDDD group, 8.9% in the 28–84 cDDD group, 11.5% in the 85–336 cDDD group, and 14.4% in the ≥337 cDDD group (p = .005). In a Cox proportional hazards analysis, the adjusted hazard ratio of dementia was 1.15 (95% CI = 0.97–1.37) in the 85–336 cDDD group, and 1.40 (95% CI = 1.12–1.75) in the ≥337 cDDD group after adjusting for covariates. Conclusions Our study indicates that higher cumulative anticholinergic exposure is associated with an increase in the risk of incident dementia in patients with LUTS aged 50 years of age and over. Either using one anticholinergic agent or switching anticholinergic agents cumulatively increases this risk. Therapeutic risks and benefits of using anticholinergics in LUTS treatment should be clinically reviewed and weighed.https://doi.org/10.1186/s12877-019-1401-yAnticholinergicsCohort studyCumulative defined daily dosesDementiaLower urinary tract symptoms |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yi-Chi Wang Yung-Liang Chen Chun-Che Huang Chung-Han Ho Yu-Tung Huang Ming-Ping Wu Ming-Jung Ou Chiu-Hsien Yang Ping-Jen Chen |
spellingShingle |
Yi-Chi Wang Yung-Liang Chen Chun-Che Huang Chung-Han Ho Yu-Tung Huang Ming-Ping Wu Ming-Jung Ou Chiu-Hsien Yang Ping-Jen Chen Cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study BMC Geriatrics Anticholinergics Cohort study Cumulative defined daily doses Dementia Lower urinary tract symptoms |
author_facet |
Yi-Chi Wang Yung-Liang Chen Chun-Che Huang Chung-Han Ho Yu-Tung Huang Ming-Ping Wu Ming-Jung Ou Chiu-Hsien Yang Ping-Jen Chen |
author_sort |
Yi-Chi Wang |
title |
Cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study |
title_short |
Cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study |
title_full |
Cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study |
title_fullStr |
Cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study |
title_full_unstemmed |
Cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study |
title_sort |
cumulative use of therapeutic bladder anticholinergics and the risk of dementia in patients with lower urinary tract symptoms: a nationwide 12-year cohort study |
publisher |
BMC |
series |
BMC Geriatrics |
issn |
1471-2318 |
publishDate |
2019-12-01 |
description |
Abstract Background Studies have shown an association between lower urinary tract symptoms (LUTS) and an increased risk of dementia. Whether anticholinergic use contributes to the development of dementia in patients with LUTS remains unknown, especially in Asian populations. This study aims to investigate the association between anticholinergic use and dementia in patients with LUTS. Methods This study included patients aged 50 years and over with newly diagnosed LUTS (January 2001 to December 2005), divided into four groups according to their cumulative defined daily doses (cDDDs) of anticholinergics: < 28 cDDDs, 28–84 cDDDs, 85–336 cDDDs, ≥337 cDDDs. Patients were followed up until dementia developed or until the end of 2012. Results We recruited a total of 16,412 patients. The incidence of dementia was 10% in the < 28 cDDD group, 8.9% in the 28–84 cDDD group, 11.5% in the 85–336 cDDD group, and 14.4% in the ≥337 cDDD group (p = .005). In a Cox proportional hazards analysis, the adjusted hazard ratio of dementia was 1.15 (95% CI = 0.97–1.37) in the 85–336 cDDD group, and 1.40 (95% CI = 1.12–1.75) in the ≥337 cDDD group after adjusting for covariates. Conclusions Our study indicates that higher cumulative anticholinergic exposure is associated with an increase in the risk of incident dementia in patients with LUTS aged 50 years of age and over. Either using one anticholinergic agent or switching anticholinergic agents cumulatively increases this risk. Therapeutic risks and benefits of using anticholinergics in LUTS treatment should be clinically reviewed and weighed. |
topic |
Anticholinergics Cohort study Cumulative defined daily doses Dementia Lower urinary tract symptoms |
url |
https://doi.org/10.1186/s12877-019-1401-y |
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