SynthesisDrugs & aging2018
Brain Over Bladder: A Systematic Review of Dual Cholinesterase Inhibitor and Urinary Anticholinergic Use.
Synthesis in Drugs & aging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Concurrent Use of Anticholinergic and Antidementia Medicines in Older Adults with Dementia: A Systematic Review of Prevalence, Predictors and Clinical Outcomes.Medical sciences (Basel, Switzerland) · 2026Pooled it
- Treatment of Apathy in Parkinson's Disease and Implications for Underlying Pathophysiology.Journal of clinical medicine · 2024Review
- Potentially Harmful Medication Prescribing by the Degree of Physician Specialization in Nursing Home Practice: An Observational Study.Journal of the American Medical Directors Association · 2023Observational
- Optimizing Medications with the Geriatrics 5Ms: An Age-Friendly Approach.Drugs & aging · 2023Article
- Anticholinergic co-prescribing in nursing home residents using cholinesterase inhibitors: Potential deprescribing cascade.Journal of the American Geriatrics Society · 2023Article
- Treatment of bladder dysfunction with solifenacin: is there a risk of dementia or cognitive impairment?Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2022Review
- The cognitive effect of anticholinergics for patients with overactive bladder.Nature reviews. Urology · 2021Review
- An examination of three prescribing cascades in a cohort of older adults with dementia.BMC geriatrics · 2021Article
- Cognitive Effects of Anticholinergic Load in Women with Overactive Bladder.Clinical interventions in aging · 2020Review
- Anticholinergic medicines use among older adults before and after initiating dementia medicines.British journal of clinical pharmacology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCase reports have demonstrated that dual use of cholinesterase inhibitors (ChIs) and urinary anticholinergics (UAChs) in older adults may be associated with delusions, aggression, changes in cognition, and anxiety, which typically resolve on drug discontinuation. Despite opposing mechanisms of action, these drugs continue to be co-prescribed.
objectiveThis systematic review evaluates cognitive and functional outcomes of dual use of ChIs and UAChs and describes its prevalence. PATIENTS AND
methodsA literature search using terms related to ChIs and UAChs was conducted. Observational or interventional studies evaluating cognitive or functional outcomes in subjects receiving dual therapy were included for the primary aim. Articles describing prevalence of dual use were included for the secondary aim.
resultsOf 1340 unique results, five studies met the inclusion criteria for the primary aim. Four of the studies assessed cognitive outcomes-three failed to identify a significant difference in cognitive function with dual use and the fourth study observed a statistically significant improvement in cognition with dual use of high-dose donepezil and solifenacin when compared with baseline. Three studies assessed functional outcomes-one revealed a 50% greater quarterly decline in activities of daily living (p = 0.01) among dual users functioning in the top quartile, another revealed significant functional improvement in dual users, and the final study did not demonstrate a significant difference. Seventeen articles were included for the secondary aim. Prevalence of dual use ranged from 1.2 to 40.5%.
conclusionThis systematic review revealed a high prevalence of dual use of ChIs and UAChs; however, there are mixed results for cognitive and functional outcomes. Results were limited by methodological flaws. Observational or interventional studies assessing dual users are lacking and further study of cognitive and functional risks of dual ChI and UACh use is needed.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.