Study challenges long-held fears about overactive bladder drugs and dementia
New research published in JAMA Network Open finds anticholinergic medications, commonly prescribed for overactive bladder (OAB), may not increase dementia risk after all compared to beta-3 agonists, the newer drug class that has been presumed to be safer for the brain.
A recent study published in JAMA Network Open challenges the common belief that anticholinergic medications, typically used to treat overactive bladder (OAB), increase the risk of dementia. Researchers at the University Hospitals Cleveland Medical Center Urology Institute analyzed data from 830,393 adults ages 40 to 90 who were newly treated for OAB between 2012 and 2025, using the Epic Cosmos electronic health record database.
The findings reveal that dementia rates were comparable across both anticholinergics and the newer drug class, beta-3 agonists. This contradicts previous assumptions that beta-3 agonists were safer for the brain. Lead author Dr. David Sheyn, a urogynecologist, suggests that OAB itself might be an early warning sign of neurodegenerative processes associated with dementia, potentially enabling early detection and intervention.
However, he emphasizes that the study's results are preliminary and require confirmation before altering clinical guidelines. While several observational studies have linked anticholinergics to dementia, this research indicates that these medications may not carry a greater long-term risk than beta-3 agonists. The study's limitations include not including patients who did not take medication and not definitively proving OAB as an early sign of dementia on its own.
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