Advertisement

Drugs & Aging

, Volume 32, Issue 7, pp 559–567 | Cite as

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

  • Susie Orme
  • Vikky Morris
  • William Gibson
  • Adrian Wagg
Review Article

Abstract

Urinary incontinence and lower urinary tract symptoms are highly prevalent in late life and are strongly associated with dementia and frailty. Incontinence is extremely common among those living in long-term care and is most commonly due to urgency incontinence. Although national and international guidelines for continence care exist, they often fail to consider the complex comorbidity found in patients with dementia and are often not followed; continence practices in long-term care may promote rather than prevent incontinence. The majority of those with dementia living in the community can be managed successfully with standard treatments, both pharmacological and non-pharmacological; the expectations and aims of treatment of both the patient and their caregivers should be considered. A dementia diagnosis does not preclude management of incontinence, but treatment options may be more limited in those with advanced dementia who are unable to retain information and modify behaviors. High-quality data to guide the choice of pharmacological agent in those with dementia are lacking. Oxybutynin has been shown to have significant adverse cognitive effects, but data to support the use of trospium, solifenacin, darifenacin, and fesoterodine are limited. No data are available for mirabegron. Neither age, frailty, nor dementia should be considered a barrier to pharmacological management, but consideration should be given to the total anticholinergic load. Evidence to guide the treatment of incontinence in this vulnerable patient group is scarce, and available guidelines adapted for each individual’s situation should be applied.

Keywords

Urinary Incontinence Nursing Home Resident Cholinesterase Inhibitor Oxybutynin Tolterodine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflicts of interest

The authors have no financial conflicts of interest that relate directly to the writing or production of this article.

Susie Orme has received speaker honoraria from and acted as a consultant for Astellas Pharma UK and Pfizer UK. William Gibson has received speaker honoraria from Pfizer Canada and Astellas Pharma Canada. Vikky Morris has received speaker honoraria from Astellas Pharma UK. Adrian Wagg has received speaker honoraria from Pfizer Europe, Pfizer Canada, Astellas Pharma Canada, and SCA; research support from Astellas Pharma and Pfizer Canada; has acted as a consultant for Pfizer Canada, Pfizer Corp, SCA, Astellas Pharma, and Astellas Pharma Canada.

References

  1. 1.
    Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–14 (discussion 14–5).Google Scholar
  2. 2.
    Brazell HD, O’Sullivan DM, Lasala CA Does the impact of urinary incontinence on quality of life differ based on age? Int Urogynecol J Pelvic Floor Dysfunct. 2013;24(12):2077–80.Google Scholar
  3. 3.
    Coyne KS, Zhou Z, Thompson C, Versi E. The impact on health-related quality of life of stress, urge and mixed urinary incontinence. BJU Int. 2003;92(7):731–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Brown JS, Vittinghoff E, Wyman JF, Stone KL, Nevitt MC, Ensrud KE, et al. Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 2000;48(7):721–5.PubMedCrossRefGoogle Scholar
  5. 5.
    Zorn BH, Montgomery H, Pieper K, Gray M, Steers WD. Urinary incontinence and depression. J Urol. 1999;162(1):82–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Tang DH, Colayco DC, Khalaf KM, Piercy J, Patel V, Globe D, et al. Impact of urinary incontinence on healthcare resource utilization, health-related quality of life and productivity in patients with overactive bladder. BJU Int. 2014;113(3):484–91.PubMedCrossRefGoogle Scholar
  7. 7.
    Ferri CP, Prince M, Brayne C, Brodaty H, Fratiglioni L, Ganguli M, et al. Global prevalence of dementia: a Delphi consensus study. Lancet. 2005;366(9503):2112–7.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement. 2013;9(1):63–75 e2.Google Scholar
  9. 9.
    Thomas P, Ingrand P, Lalloue F, Hazif-Thomas C, Billon R, Vieban F, et al. Reasons of informal caregivers for institutionalizing dementia patients previously living at home: the Pixel study. Int J Geriatr Psychiatry. 2004;19(2):127–35.PubMedCrossRefGoogle Scholar
  10. 10.
    Roe B, Flanagan L, Jack B, Shaw C, Williams K, Chung A, et al. Systematic review of descriptive studies that investigated associated factors with the management of incontinence in older people in care homes. Int J Older people Nurs. 2013;8(1):29–49.PubMedCrossRefGoogle Scholar
  11. 11.
    Kamiya M, Sakurai T, Ogama N, Maki Y, Toba K. Factors associated with increased caregivers’ burden in several cognitive stages of Alzheimer’s disease. Geriatr Gerontol Int. 2014;14(Suppl 2):45–55.PubMedCrossRefGoogle Scholar
  12. 12.
    Ouslander JG, Zarit SH, Orr NK, Muira SA. Incontinence among elderly community-dwelling dementia patients. Characteristics, management, and impact on caregivers. J Am Geriatr Soc. 1990;38(4):440–5.PubMedCrossRefGoogle Scholar
  13. 13.
    National Clinical Guideline Centre. The management of lower urinary tract symptoms in men. London. 2010. http://www.nice.org.uk/guidance/CG97. Accessed 26 June 2015.
  14. 14.
    The Management of Urinary Incontinence in Women. Urinary incontinence in women. London. 2013. https://www.nice.org.uk/guidance/cg171. Accessed 26 June 2015.
  15. 15.
    Lucas MG, Bosch RJ, Burkhard FC, Cruz F, Madden TB, Nambiar AK, et al. European Association of Urology guidelines on assessment and nonsurgical management of urinary incontinence. Actas Urol Esp. 2013;37(4):199–213.PubMedCrossRefGoogle Scholar
  16. 16.
    Hagglund D. A systematic literature review of incontinence care for persons with dementia: the research evidence. J Clin Nurs. 2010;19(3–4):303–12.PubMedCrossRefGoogle Scholar
  17. 17.
    Ouslander JG, Uman GC, Urman HN, Rubenstein LZ. Incontinence among nursing home patients: clinical and functional correlates. J Am Geriatr Soc. 1987;35(4):324–30.PubMedCrossRefGoogle Scholar
  18. 18.
    Østbye T, Borrie MJ, Hunskaar S. The prevalence of urinary incontinence in elderly Canadians and its association with dementia, ambulatory function, and institutionalization. Norsk Epidemiol. 2009;8(2). www.ntnu.no/ojs/index.php/norepid/article/view/465.
  19. 19.
    Huang AJ, Brown JS, Thom DH, Fink HA, Yaffe K, Study of Osteoporotic Fractures Research Group. Urinary incontinence in older community-dwelling women: the role of cognitive and physical function decline. Obstetr Gynecol. 2007;109(4):909–16.CrossRefGoogle Scholar
  20. 20.
    Ostbye T, Seim A, Krause KM, Feightner J, Hachinski V, Sykes E, et al. A 10-year follow-up of urinary and fecal incontinence among the oldest old in the community: the Canadian Study of Health and Aging. Can J Aging. 2004;23(4):319–31.Google Scholar
  21. 21.
    Byles J, Millar CJ, Sibbritt DW, Chiarelli P. Living with urinary incontinence: a longitudinal study of older women. Age Ageing. 2009;38(3):333–8 (discussion 251).Google Scholar
  22. 22.
    Thom DH, Haan MN, Van Den Eeden SK. Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality. Age Ageing. 1997;26(5):367–74.PubMedCrossRefGoogle Scholar
  23. 23.
    Alcorn G, Law E, Connelly PJ, Starr JM. Urinary incontinence in people with Alzheimer’s disease. Int J Geriatr Psychiatry [Letter]. 2014;29(1):107–9.Google Scholar
  24. 24.
    Grant RL, Drennan VM, Rait G, Petersen I, Iliffe S. First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database. PLoS medicine. 2013;10(8):e1001505.PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Resnick NM, Yalla SV, Laurino E. The pathophysiology of urinary incontinence among institutionalized elderly persons. N Engl J Med. 1989;320(1):1–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Lee SH, Cho ST, Na HR, Ko SB, Park MH. Urinary incontinence in patients with Alzheimer’s disease: relationship between symptom status and urodynamic diagnoses. Int J Urol. 2014;21(7):683–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Cassells C, Watt E. The impact of incontinence on older spousal caregivers. J Adv Nurs. 2003;42(6):607–16.PubMedCrossRefGoogle Scholar
  28. 28.
    Stewart TV, Loskutova N, Galliher JM, Warshaw GA, Coombs LJ, Staton EW, et al. Practice patterns, beliefs, and perceived barriers to care regarding dementia: a report from the American Academy of Family Physicians (AAFP) national research network. J Am Board Fam Med. 2014;27(2):275–83.Google Scholar
  29. 29.
    Fox C, Richardson K, Maidment ID, Savva GM, Matthews FE, Smithard D, et al. Anticholinergic medication use and cognitive impairment in the older population: the medical research council cognitive function and ageing study. J Am Geriatr Soc. 2011;59(8):1477–83.PubMedCrossRefGoogle Scholar
  30. 30.
    Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7.PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Fox C, Livingston G, Maidment ID, Coulton S, Smithard DG, Boustani M, et al. The impact of anticholinergic burden in Alzheimer’s dementia-the LASER-AD study. Age Ageing. 2011;40(6):730–5.PubMedCrossRefGoogle Scholar
  32. 32.
    Schussler S, Dassen T, Lohrmann C. Care dependency and nursing care problems in nursing home residents with and without dementia: a cross-sectional study. Aging Clin Exp Res. 2014. doi: 10.1007/s40520-014-0298-8.
  33. 33.
    Xu D, Kane RL. Effect of urinary incontinence on older nursing home residents’ self-reported quality of life. J Am Geriatr Soc. 2013;61(9):1473–81.PubMedCrossRefGoogle Scholar
  34. 34.
    Rose A, Thimme A, Halfar C, Nehen HG, Rubben H. Severity of urinary incontinence of nursing home residents correlates with malnutrition, dementia and loss of mobility. Urol Int. 2013;91(2):165–9.PubMedCrossRefGoogle Scholar
  35. 35.
    Lawhorne LW, Ouslander JG, Parmelee PA, Resnick B, Calabrese B. Urinary incontinence: a neglected geriatric syndrome in nursing facilities. J Am Med Dir Assoc. 2008;9(1):29–35.PubMedCrossRefGoogle Scholar
  36. 36.
    National Institute for Health and Care Excellence. Urinary incontinence in women: quality standard 77. London: NICE; 2015. Available from: https://www.nice.org.uk/guidance/qs77/chapter/introduction. Accessed 22 June 2015.
  37. 37.
    Wagg A, Gibson W, Ostaszkiewicz J, Johnson T 3rd, Markland A, Palmer MH, et al. Urinary incontinence in frail elderly persons: report from the 5th international consultation on incontinence. Neurourology and Urodynamics. 2014.Google Scholar
  38. 38.
    Lee KS, Lee HW, Choo MS, Paick JS, Lee JG, Seo JT, et al. Urinary urgency outcomes after propiverine treatment for an overactive bladder: the ‘Propiverine study on overactive bladder including urgency data’. BJU Int. 2010;105(11):1565–70.PubMedCrossRefGoogle Scholar
  39. 39.
    Ouslander JG, Schnelle JF, Uman G, Fingold S, Nigam JG, Tuico E, et al. Predictors of successful prompted voiding among incontinent nursing home residents. JAMA. 1995;273(17):1366–70.PubMedCrossRefGoogle Scholar
  40. 40.
    Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2000;2:CD002113.Google Scholar
  41. 41.
    Schnelle JF, Cadogan MP, Grbic D, Bates-Jensen BM, Osterweil D, Yoshii J, et al. A standardized quality assessment system to evaluate incontinence care in the nursing home. J Am Geriatr Soc. 2003;51(12):1754–61.PubMedCrossRefGoogle Scholar
  42. 42.
    Schnelle JF, Cadogan MP, Yoshii J, Al-Samarrai NR, Osterweil D, Bates-Jensen BM, et al. The minimum data set urinary incontinence quality indicators: do they reflect differences in care processes related to incontinence? Med Care. 2003;41(8):909–22.PubMedCrossRefGoogle Scholar
  43. 43.
    Drennan VM, Greenwood N, Cole L, Fader M, Grant R, Rait G, et al. Conservative interventions for incontinence in people with dementia or cognitive impairment, living at home: a systematic review. BMC Geriatr. 2012;12:77.PubMedCentralPubMedCrossRefGoogle Scholar
  44. 44.
    Drennan VM, Norrie C, Cole L, Donovan S. Addressing incontinence for people with dementia living at home: a documentary analysis of local English community nursing service continence policies and clinical guidance. J Clin Nurs. 2013;22(3–4):339–46.PubMedCrossRefGoogle Scholar
  45. 45.
    National Institute for Health and Care Excellence. Urinary incontinence in neurological disease: Management of lower urinary tract dysfunction in neurological disease. London: NICE; 2012; Available from: https://www.nice.org.uk/guidance/cg148/chapter/1-guidance. Accessed 22 June 2015.
  46. 46.
    Sink KM, Thomas J 3rd, Xu H, Craig B, Kritchevsky S, Sands LP. Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes. J Am Geriatr Soc. 2008;56(5):847–53.PubMedCrossRefGoogle Scholar
  47. 47.
    Lackner TE, Wyman JF, McCarthy TC, Monigold M, Davey C. Efficacy of oral extended-release oxybutynin in cognitively impaired older nursing home residents with urge urinary incontinence: a randomized placebo-controlled trial. J Am Med Dir Assoc. 2011;12(9):639–47.PubMedCrossRefGoogle Scholar
  48. 48.
    Ouslander JG, Blaustein J, Connor A, Pitt A. Habit training and oxybutynin for incontinence in nursing home patients: a placebo-controlled trial. J Am Geriatr Soc. 1988;36(1):40–6.PubMedCrossRefGoogle Scholar
  49. 49.
    Ouslander JG, Schnelle JF, Uman G, Fingold S, Nigam JG, Tuico E, et al. Does oxybutynin add to the effectiveness of prompted voiding for urinary incontinence among nursing home residents? A placebo-controlled trial. J Am Geriatr Soc. 1995;43(6):610–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Terry AV Jr, Buccafusco JJ. The cholinergic hypothesis of age and Alzheimer’s disease-related cognitive deficits: recent challenges and their implications for novel drug development. J Pharmacol Exp Ther. 2003;306(3):821–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Flicker C, Ferris SH, Serby M. Hypersensitivity to scopolamine in the elderly. Psychopharmacology. 1992;107(2–3):437–41.PubMedCrossRefGoogle Scholar
  52. 52.
    Ancelin ML, Artero S, Portet F, Dupuy AM, Touchon J, Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. BMJ. 2006;332(7539):455–9.PubMedCentralPubMedCrossRefGoogle Scholar
  53. 53.
    Carriere I, Fourrier-Reglat A, Dartigues JF, Rouaud O, Pasquier F, Ritchie K, et al. Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study. Arch Inter Med. 2009;169(14):1317–24.CrossRefGoogle Scholar
  54. 54.
    Low LF, Anstey KJ, Sachdev P. Use of medications with anticholinergic properties and cognitive function in a young-old community sample. Int J Geriatr Psychiatry. 2009;24(6):578–84.PubMedCrossRefGoogle Scholar
  55. 55.
    Campbell N, Boustani M, Limbil T, Ott C, Fox C, Maidment I, et al. The cognitive impact of anticholinergics: a clinical review. Clin Interv Aging. 2009;4:225–33.PubMedCentralPubMedGoogle Scholar
  56. 56.
    Jewart RD, Green J, Lu CJ, Cellar J, Tune LE. Cognitive, behavioral, and physiological changes in Alzheimer disease patients as a function of incontinence medications. Am J Geriatr Psychiatry. 2005;13(4):324–8.PubMedCrossRefGoogle Scholar
  57. 57.
    Paquette A, Gou P, Tannenbaum C. Systematic review and meta-analysis: do clinical trials testing antimuscarinic agents for overactive bladder adequately measure central nervous system adverse events? J Am Geriatr Soc. 2011;59(7):1332–9.PubMedCrossRefGoogle Scholar
  58. 58.
    Movig KL, Egberts AC, Lenderink AW, Leufkens HG. Association between oxybutynin and neuropsychiatric adverse effects not confirmed in daily practice. J Am Geriatr Soc. 2001;49(2):234–5.PubMedCrossRefGoogle Scholar
  59. 59.
    Tsao JW, Heilman KM. Transient memory impairment and hallucinations associated with tolterodine use. N Engl J Med. 2003;349(23):2274–5.PubMedCrossRefGoogle Scholar
  60. 60.
    Donnellan CA, Fook L, McDonald P, Playfer JR. Oxybutynin and cognitive dysfunction. BMJ. 1997;315(7119):1363–4.PubMedCentralPubMedCrossRefGoogle Scholar
  61. 61.
    Salvatore S, Serati M, Cardozo L, Uccella S, Bolis P. Cognitive dysfunction with tolterodine use. Am J Obstet Gynecol. 2007;197(2):e8.PubMedCrossRefGoogle Scholar
  62. 62.
    Shiota T, Torimoto K, Momose H, Nakamuro T, Mochizuki H, Kumamoto H, et al. Temporary cognitive impairment related to administration of newly developed anticholinergic medicines for overactive bladder: two case reports. BMC Res Notes. 2014;7:672.PubMedCentralPubMedCrossRefGoogle Scholar
  63. 63.
    Herberg K. Alltags - und Verkehrrssicherheit unter Inkontinenz - Medikation. Neue Untersuchungen zum Sicherheitspotential urologischer Anticholinergika. Med Welt. 1999;50:217–22.Google Scholar
  64. 64.
    Pietzko A, Dimpfel W, Schwantes U, Topfmeier P. Influences of trospium chloride and oxybutynin on quantitative EEG in healthy volunteers. Eur J Clin Pharmacol. 1994;47(4):337–43.PubMedCrossRefGoogle Scholar
  65. 65.
    Lipton RB, Kolodner K, Wesnes K. Assessment of cognitive function of the elderly population: effects of darifenacin. J Urol. 2005;173(2):493–8.PubMedCrossRefGoogle Scholar
  66. 66.
    Kay G, Crook T, Rekeda L, Lima R, Ebinger U, Arguinzoniz M, et al. Differential effects of the antimuscarinic agents darifenacin and oxybutynin ER on memory in older subjects. Eur Urol. 2006;50(2):317–26.PubMedCrossRefGoogle Scholar
  67. 67.
    Kay G, Maruff P, Scholfield D, Malhotra B, Whelan L, Darekar A, Martire D. Evaluation of cognitive function in healthy older adultss treated with fesoterodine. Neurourol Urodyn. 2011;30(6):961–3.Google Scholar
  68. 68.
    Yamamoto S, Maruyama S, Ito Y, Kawamata M, Nishiyama S, Ohba H, et al. Effect of oxybutynin and imidafenacin on central muscarinic receptor occupancy and cognitive function: a monkey PET study with [(11)C](+)3-MPB. Neuroimage. 2011;58(1):1–9.PubMedCrossRefGoogle Scholar
  69. 69.
    Katz IR, Sands LP, Bilker W, DiFilippo S, Boyce A, D’Angelo K. Identification of medications that cause cognitive impairment in older people: the case of oxybutynin chloride. J Am Geriatr Soc. 1998;46(1):8–13.PubMedCrossRefGoogle Scholar
  70. 70.
    Lackner TE, Wyman JF, McCarthy TC, Monigold M, Davey C. Randomized, placebo-controlled trial of the cognitive effect, safety, and tolerability of oral extended-release oxybutynin in cognitively impaired nursing home residents with urge urinary incontinence. J Am Geriatr Soc. 2008;56(5):862–70.PubMedCrossRefGoogle Scholar
  71. 71.
    Kay GS, D., MacDiarmid, S, McIlwain,M., Dahl, N. Are the effects of oxybuytnin on cognition dependent upon the route of administration—topical or oral? A double-blind, placebo controlled study employing sensitive cognitive and psychomotor testing. Neurourol Urodyn. 2009;28(7):Abs 111.Google Scholar
  72. 72.
    Nye AM, Clinard VB, Barnes CL. Medication nonadherence secondary to drug-induced memory loss. Consult Pharm. 2010;25(2):117–21.PubMedCrossRefGoogle Scholar
  73. 73.
    Gulsun M, Pinar M, Sabanci U. Psychotic disorder induced by oxybutynin: Presentation of two cases. Clin Drug Investig. 2006;26(10):603–6.PubMedCrossRefGoogle Scholar
  74. 74.
    Oelke M, Murgas S, Schneider T, Heßdörfer E. Influence of propiverine ER 30 mg once daily on cognitive function in elderly female and male patients with overactive bladder: a non-interventional study to assess real life data [abstract]. Neurourol Urodyn. 2013;32(6):800–2.Google Scholar
  75. 75.
    Wesnes KA, Edgar C, Tretter RN, Bolodeoku J. Exploratory pilot study assessing the risk of cognitive impairment or sedation in the elderly following single doses of solifenacin 10 mg. Expert Opinion Drug Saf. 2009;8(6):615–26.CrossRefGoogle Scholar
  76. 76.
    Wagg A, Dale M, Tretter R, Stow B, Compion G. Randomised, multicentre, placebo-controlled, double-blind crossover study investigating the effect of solifenacin and oxybutynin in elderly people with mild cognitive impairment: the SENIOR study. Eur Urol. 2013;64(1):74–81.Google Scholar
  77. 77.
    Kay G, Kardiasmenos, K., Crook, T. Differential effects of the antimuscarinic agents tolterodine tartrate ER and oxybutynin chloride ER on recent memory in older subjects. In: Proceedings of the 36th meeting of the International Continence Society. 2006;25(6):P087.Google Scholar
  78. 78.
    Womack KB, Heilman KM. Tolterodine and memory: dry but forgetful. Arch Neurol. 2003;60(5):771–3.PubMedCrossRefGoogle Scholar
  79. 79.
    Staskin D, Kay G, Tannenbaum C, Goldman HB, Bhashi K, Ling J, Oefelein MG. Trospium chloride has no effect on memory testing and is assay undetectable in the central nervous system of older patients with overactive bladder. Int J Clin Pract. 2010;64(9):1294–300.PubMedCrossRefGoogle Scholar
  80. 80.
    Staskin D, Kay G, Tannenbaum C, Goldman HB, Bhashi K, Ling J, Oefelein MG. Trospium chloride is undetectable in older human central nervous system. J Am Geriatr Soc. 2010;58(8):1618–9.PubMedCrossRefGoogle Scholar
  81. 81.
    Diefenbach K, Donath F, Maurer A, Quispe Bravo S, Wernecke KD, Schwantes U, et al. Randomised, double-blind study of the effects of oxybutynin, tolterodine, trospium chloride and placebo on sleep in healthy young volunteers. Clin Drug Investig. 2003;23(6):395–404.PubMedCrossRefGoogle Scholar
  82. 82.
    Diefenbach K, Arold G, Wollny A, Schwantes U, Haselmann J, Roots I. Effects on sleep of anticholinergics used for overactive bladder treatment in healthy volunteers aged > or = 50 years. BJU Int. 2005;95(3):346–9.PubMedCrossRefGoogle Scholar
  83. 83.
    Diefenbach K, Jaeger K, Wollny A, Penzel T, Fietze I, Roots I. Effect of tolterodine on sleep structure modulated by CYP2D6 genotype. Sleep Med. 2008;9(5):579–82.PubMedCrossRefGoogle Scholar
  84. 84.
    Campbell N, Perkins A, Hui S, Khan B, Boustani M. Association between prescribing of anticholinergic medications and incident delirium: a cohort study. J Am Geriatr Soc. 2011;59(Suppl 2):S277–81.PubMedCentralPubMedCrossRefGoogle Scholar
  85. 85.
    Stuhec M. Solifenacin-induced delirium and hallucinations. General hospital psychiatry. 2013;35(6):682 e3–4.Google Scholar
  86. 86.
    Williams SG, Staudenmeier J. Hallucinations with tolterodine. Psychiatr Serv. 2004;55(11):1318–9.PubMedCrossRefGoogle Scholar
  87. 87.
    van Munster BC, Thomas C, Kreisel SH, Brouwer JP, Nanninga S, Kopitz J, et al. Longitudinal assessment of serum anticholinergic activity in delirium of the elderly. J Psychiatr Res. 2012;46(10):1339–45.PubMedCrossRefGoogle Scholar
  88. 88.
    Hashimoto M, Imamura T, Tanimukai S, Kazui H, Mori E. Urinary incontinence: an unrecognised adverse effect with donepezil. Lancet. 2000;356(9229):568.PubMedCrossRefGoogle Scholar
  89. 89.
    Starr JM. Cholinesterase inhibitor treatment and urinary incontinence in Alzheimer’s disease. J Am Geriatr Soc. 2007;55(5):800–1.PubMedCrossRefGoogle Scholar
  90. 90.
    Siegler EL, Reidenberg M. Treatment of urinary incontinence with anticholinergics in patients taking cholinesterase inhibitors for dementia. Clin Pharmacol Ther. 2004;75(5):484–8.PubMedCrossRefGoogle Scholar
  91. 91.
    Gill SS, Mamdani M, Naglie G, Streiner DL, Bronskill SE, Kopp A, et al. A prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs. Arch Intern Med. 2005;165(7):808–13.PubMedCrossRefGoogle Scholar
  92. 92.
    Isik AT, Celik T, Bozoglu E, Doruk H. Trospium and cognition in patients with late onset Alzheimer disease. J Nutr Health Aging. 2009;13(8):672–6.PubMedCrossRefGoogle Scholar
  93. 93.
    Sakakibara R, Ogata T, Uchiyama T, Kishi M, Ogawa E, Isaka S, et al. How to manage overactive bladder in elderly individuals with dementia? A combined use of donepezil, a central acetylcholinesterase inhibitor, and propiverine, a peripheral muscarine receptor antagonist. J Am Geriatr Soc. 2009;57(8):1515–7.PubMedCrossRefGoogle Scholar
  94. 94.
    Wagg A, Cardozo L, Nitti VW, Castro-Diaz D, Auerbach S, Blauwet MB, Siddiqui E. The efficacy and tolerability of the beta-3 adrenoreceptor agonist mirabegron for the treatment of symptoms of overactive bladder in older patients. Age Ageing. 2014;43(5):666–75.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Susie Orme
    • 1
  • Vikky Morris
    • 2
  • William Gibson
    • 3
  • Adrian Wagg
    • 3
  1. 1.Barnsley Hospital NHS Foundation TrustBarnsleyUK
  2. 2.Musgrove Park Hospital Foundation TrustTauntonUK
  3. 3.Division of Geriatric MedicineUniversity of AlbertaEdmontonCanada

Personalised recommendations