Antimuscarinic medication used for the treatment of overactive bladder in women and the risk of cognitive decline, cardiovascular disease and mortality—a systematic review.
Background Overactive bladder is common among older women and often managed with antimuscarinic agents. These medications contribute to cumulative anticholinergic burden, which has been associated with adverse outcomes including cognitive decline, cardiovascular morbidity and mortality. This study a...
| Publicado en: | Age & Ageing Vol. 55; no. 2; pp. 1 - 12 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Feb2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=192513155&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 192513155 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Feb2026 vid: 55 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 192513155 10.1093/ageing/afag027 ppf: 1 ppct: 11 formats: tig: atl: Antimuscarinic medication used for the treatment of overactive bladder in women and the risk of cognitive decline, cardiovascular disease and mortality—a systematic review. aug: au: Maguire, Turlough Marr, Calum Barry, Heather Abdel-Fattah, Mohamed McGuinness, Bernadette affil: School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Institute of Clinical Sciences Block A, Queen's University Belfast, Belfast, UK School of Pharmacy, Queen's University Belfast, Belfast, UK School Medicine, Medical Sciences and Nutrition, Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, UK su: Competency assessment (Law) Psychology of women Memory Adults Dementia risk factors Cognition disorder risk factors Mortality risk factors Risk assessment Medical information storage & retrieval systems Cognitive testing CINAHL database Cardiovascular diseases risk factors Meta-analysis Descriptive statistics Systematic reviews Odds ratio MEDLINE Muscarinic antagonists Confidence intervals Data analysis software Overactive bladder Patient aftercare Psychology information storage & retrieval systems sug: subj: Competency assessment (Law) Psychology of women Memory Adults Home Health Care Services Offices of Mental Health Practitioners (except Physicians) Dementia risk factors Cognition disorder risk factors Mortality risk factors Risk assessment Medical information storage & retrieval systems Cognitive testing CINAHL database Cardiovascular diseases risk factors Meta-analysis Descriptive statistics Systematic reviews Odds ratio MEDLINE Muscarinic antagonists Confidence intervals Data analysis software Overactive bladder Patient aftercare Psychology information storage & retrieval systems keyword: antimuscarinic cardiovascular cardiovascular diseases cardiovascular system cognitive cognitive impairment copyrightHolder:British Geriatrics Society copyrightYear:2026 dementia follow-up https://dx.doi.org/10.1093/ageing/afag027 inLanguage:en mortality muscarinic antagonists older adult older people overactive bladder publisher:Oxford University Press randomization risks sameAs:https://pubmed.ncbi.nlm.nih.gov/41686541/ systematic review urinary bladder antimuscarinic cardiovascular cardiovascular diseases cardiovascular system cognitive cognitive impairment copyrightHolder:British Geriatrics Society copyrightYear:2026 dementia follow-up https://dx.doi.org/10.1093/ageing/afag027 inLanguage:en mortality muscarinic antagonists older adult older people overactive bladder publisher:Oxford University Press randomization risks sameAs:https://pubmed.ncbi.nlm.nih.gov/41686541/ systematic review urinary bladder ab: Background Overactive bladder is common among older women and often managed with antimuscarinic agents. These medications contribute to cumulative anticholinergic burden, which has been associated with adverse outcomes including cognitive decline, cardiovascular morbidity and mortality. This study aimed to evaluate the association between bladder antimuscarinics and these outcomes in adult women. Methods A systematic review and meta-analysis were conducted following PROSPERO registration. Six databases were searched up to 15 January 2025. Eligible studies included adult women (≥18 years, >50% female sample) exposed to antimuscarinics, compared to placebo or non-use and reported outcomes of cognitive decline, cardiovascular disease or mortality. Randomised controlled trials (RCTs), observational cohort studies and case–control studies were included. Data were synthesised using a random effects model. Results Thirty-seven studies met inclusion criteria, all in older populations. Meta-analysis of eight RCTs (n = 675 participants) found no significant cognitive effects at mean follow-up of 19.5 days [standardised mean difference −0.23; 95% confidence interval (CI) −0.61 to 0.15, I2 75%]. Ten cohort studies indicated increased risk of cognitive decline or dementia at mean follow-up of 7.5 years, with a pooled odds ratio (OR) of 1.33 (95% CI 1.10–1.61) and a hazard ratio (HR) of 1.24 (95% CI 1.19–1.30). Two studies reported increased cardiovascular risk (OR 1.13; 95% CI 1.01–1.25) and three studies reported increased mortality (OR 1.26; 95% CI 1.17–1.36). All studies demonstrated concerns regarding risk of bias. Conclusion Bladder antimuscarinics may increase long-term risks of dementia, cardiovascular events and mortality in older women. While RCTs do not suggest direct cognitive harm, caution is advised. These findings are constrained by the low quality of the underlying evidence. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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