Anticholinergics link to higher dementia risk in older women
Anticholinergic use was associated with higher incident dementia risk compared with β3-agonist use (hazard ratio, 1.49; 95% CI, 1.04–2.13).
International Journal of Urology
In a retrospective study of women aged 65 to 84 years in Japan, researchers compared long-term outcomes between two classes of overactive bladder drugs. The analysis followed 1,605 new users of anticholinergic agents and 2,189 new users of β3-adrenergic receptor agonists who maintained continuous treatment for at least one year.
Anticholinergic use was associated with an increased risk of claims-defined incident dementia compared with β3-agonist therapy. In contrast, researchers observed no significant difference between the two drug classes for worsening long-term care needs (hazard ratio, 1.03; 95% CI, 0.87–1.22). Median electronic Frailty Index scores also did not differ significantly between the treatment groups across five years of follow-up.
Why it matters
Identifying medication classes linked to cognitive decline helps guide safer prescribing practices for common age-related conditions. Choosing alternatives with lower neurodegenerative risks may help preserve brain health in older adults.
Caveats
Because this was an observational study using administrative claims data, residual confounding and differential dementia ascertainment cannot be excluded.
The paper
Overactive Bladder Pharmacotherapy and Long-Term Care Needs, Dementia, and Frailty in Older Women
Shizuoka Cancer Center · Shizuoka Graduate University of Public Health
International Journal of Urology · 1 Oct 2026