ArticleBJU international2020
Increased risk of dementia among patients with overactive bladder treated with an anticholinergic medication compared to a beta-3 agonist: a population-based cohort study.
Article in BJU international, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 48 papers, 5 of them syntheses that pooled it.
What it found
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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.
Vaginal Estradiol vs Oral Beta-3 Agonist for Treatment of Overactive Bladder Syndrome: A Single-Therapy, Double-Blind, Randomized Controlled Trial
Urinary Tract Infection Prophylaxis In Intradetrusor OnabotulinumtoxinA Procedures: A Randomized Controlled Trial
Who cites it
48 citing papers in PubMed, 5 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Risk of dementia in patients treated with anticholinergics for overactive bladder syndrome: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Development of the Swedish anticholinergic burden scale (Swe-ABS).BMC geriatrics · 2023Pooled it
- The gut, vaginal, and urine microbiome in overactive bladder: a systematic review.International urogynecology journal · 2022Pooled it
- Anticholinergic burden (prognostic factor) for prediction of dementia or cognitive decline in older adults with no known cognitive syndrome.The Cochrane database of systematic reviews · 2021Pooled it
- Increased risk of incident dementia following use of anticholinergic agents: A systematic literature review and meta-analysis.Neurourology and urodynamics · 2021Pooled it
- Efficacy and Safety of Vibegron for Persistent Symptoms of Overactive Bladder in Men Being Pharmacologically Treated for Benign Prostatic Hyperplasia: Results From the Phase 3 Randomized Controlled COURAGE Trial.The Journal of urology · 2024Trial
- Trial
- Neurogenic lower urinary tract dysfunction in ageing men with spinal cord injury.Nature reviews. Urology · 2026Review
- Trends and Racial/Ethnic Disparities in Pharmacologic and Surgical Management of Treated Female Patients With Urinary Incontinence.Neurourology and urodynamics · 2026Observational
- Letter to Editor on: "Trends and Racial/Ethnic Disparities in Pharmacologic and Surgical Management of Treated Female Patients With Urinary Incontinence".Neurourology and urodynamics · 2026Article
- Baseline Anticholinergic Medication Burden in Patients with Overactive Bladder.International urogynecology journal · 2026Article
- Navigating the challenges of overactive bladder management in women.World journal of urology · 2026Review
- Side effects of medical therapy for non-neurogenic lower urinary tract symptoms in children: a UK-based single centre retrospective case-note review.BMJ paediatrics open · 2026Article
- Article
- 'BJUI Clinical Dilemma': the overactive bladder.BJU international · 2026Article
- A Retrospective Database Analysis of Anticholinergic Burden Among Older Patients With and Without Overactive Bladder in South Korea.International neurourology journal · 2025Article
- The Impact of Real-world Use of Overactive Bladder Medications on Dementia Risk in Younger Adults.European urology open science · 2025Article
- Impact of β3-adrenergic receptor agonist on tumor progression and metastasis in renal cell carcinoma models.Cancer cell international · 2025Article
- Pharmacotherapy for overactive bladder syndrome and the risk of incident dementia.World journal of urology · 2025Article
- Satisfaction and persistence with vibegron in the first 6 months of overactive bladder treatment: interim results of the phase 4, real-world COMPOSUR study.BMC urology · 2025Observational
Corrections and comments
- Commented on byGeriatrics.2021
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo determine if there is an increased risk of dementia among patients with overactive bladder (OAB) starting an anticholinergic medication compared to those starting a beta-3 agonist.
methodsWe conducted a population-based, retrospective, matched cohort study using linked administrative data from Ontario, Canada from 2010 to 2018. We matched 47 324 new users of anticholinergic medications (oxybutynin, tolterodine, solifenacin, darifenacin, fesoterodine, trospium) to 23 662 new users of a beta-3 agonist medication (mirabegron); all of the included medications are only indicated for the treatment of OAB. We measured 75 baseline variables (including comorbid conditions, recent medications, and prior healthcare utilization) and used these to create a propensity score; groups were similar across all measured variables after matching. The primary exposure was the class of OAB medication (anticholinergic or beta-3 agonist). The primary outcome was dementia using a validated administrative data definition.
resultsThe most common anticholinergics used were tolterodine (40%), oxybutynin (29%) and solifenacin (26%). The median (interquartile range [IQR]) prescription duration of anticholinergics was 30 (30-170) days. The median (IQR) prescription duration of a beta-3 agonist (mirabegron) was 64 (30-317) days. There was an increased risk of dementia among anticholinergic users compared to beta-3 agonist users (hazard ratio 1.23, 95% confidence interval 1.12-1.35). There was a significant effect modification based on both gender and age; men and those aged ≤75 years on anticholinergics had the highest risk of dementia relative to similar beta-3 agonist users.
conclusionsThe use of anticholinergic medications among patients with OAB was associated with an increased risk of new-onset dementia compared to beta-3 agonist users. These results address the potential protopathic bias present in other studies on this topic and support the association between anticholinergic medication use and dementia.
Indexed as
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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.