Evidence map›Paper›PMID 34429535›Full record

ReviewNature reviews. Urology2021

The cognitive effect of anticholinergics for patients with overactive bladder.

Blayne Welk, Kathryn Richardson, Jalesh N Panicker

Abstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
10.6field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 68 citations in OpenAlex.

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  10. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
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  12. Diagnosis and management of urinary incontinence in females.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 2 countries.

Blayne Welk *Department of Surgery and Epidemiology & Biostatistics, Western University, London, Ontario, Canada. bkwelk@gmail.com.ORCID http://orcid.org/0000-0001-7093-558X
Kathryn Richardson *Norwich Medical School, University of East Anglia, Norwich, UK.
Jalesh N PanickerDepartment of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, and UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.ORCID http://orcid.org/0000-0001-5190-3259
National Hospital for Neurology and Neurosurgery · GBUniversity of East Anglia · GBWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Overactive bladder (OAB) is often treated with medications that block the cholinergic receptors in the bladder (known as anticholinergics). The effect of this medication class on cognition and risk of dementia has been increasingly studied over the past 40 years after initial studies suggested that the anticholinergic medication class could affect memory. Short-term randomized clinical trials demonstrated that the administration of the anticholinergic oxybutynin leads to impaired memory and attention, and large, population-based studies showed associations between several different anticholinergic medications and dementia. However, trials involving anticholinergics other than oxybutynin have not shown such substantial effects on short-term cognitive function. This discordance in results between short-term cognitive safety of OAB anticholinergics and the long-term increased dementia risk could be explained by the high proportion of patients using oxybutynin in the OAB subgroups of the dementia studies, or a study duration that was too short in the prospective clinical trials on cognition with other OAB anticholinergics. Notably, all studies must be interpreted in the context of potential confounding factors, such as when prodromal urinary symptoms associated with the early stages of dementia lead to an increase in OAB medication use, rather than the use of OAB medication causing dementia. In patients with potential risk factors for cognitive impairment, the cautious use of selected OAB anticholinergic agents with favourable physicochemical and pharmacokinetic properties and clinical trial evidence of cognitive safety might be appropriate.

Indexed as

CognitionBenzhydryl CompoundsBenzofuransCholinergic AntagonistsCognitive DysfunctionDementiaHumansMandelic AcidsProdromal SymptomsPyrrolidinesRisk AssessmentRisk FactorsSolifenacin SuccinateTolterodine TartrateUrinary Bladder, OveractiveBenzhydryl CompoundsBenzofuransCholinergic AntagonistsdarifenacinfesoterodineMandelic AcidsoxybutyninPyrrolidinesSolifenacin SuccinateTolterodine Tartrate

Identifiers

PMID34429535
OpenAlexW3195984645

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.