Use of bladder antimuscarinics is associated with an increased risk of dementia: a retrospective population-based case-control study

The association between bladder antimuscarinic use and dementia development is unclear. We used data from the Taiwan National Health Insurance Research Database to determine the association between the exposure dose and duration of bladder antimuscarinics and the subsequent dementia risk. We enrolled participants aged 55 years or more and defined a dementia cohort (International Classification of Diseases, Ninth Revision, Clinical Modification codes 290, 294.1, and 331.0). We used a propensity score matching method, and randomly enrolled two controls without dementia. We evaluated dementia risk with respect to the exposure dose and duration of treatment with seven bladder antimuscarinics (oxybutynin, propiverine, tolterodine, solifenacin, trospium, darifenacin, and fesoterodine) used for at least 1 year before the index date, after adjusting for age, sex, comorbidities, and medications. The dementia risk was 2.46-fold (95% confidence interval: 2.22-2.73) higher in Taiwanese patients who used bladder antimuscarinics for >= 1 year than in those who were not exposed to this treatment. The risk proportionally increased with increasing doses of antimuscarinics for less than 4 years. Taiwanese patients aged 55 years or more on bladder antimuscarinics exhibited a higher risk of dementia. Additional studies in other countries are required to determine whether this result is valid worldwide.

Automated summary

This study used data from the Taiwan National Health Insurance Research Database to investigate the association between bladder antimuscarinic use and dementia risk in patients aged 55 years or older. The study found that Taiwanese patients who used bladder antimuscarinics for more than 1 year had a significantly higher risk of developing dementia compared to those who did not use this treatment. Additionally, the risk of dementia increased proportionally with higher doses of antimuscarinics and longer duration of use.