Putting Unexpected Safety Findings for Overactive Bladder Treatments in Context

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Observational studies have associated anticholinergic medication exposure with a higher incidence of dementia.
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Guidelines advise caution with anticholinergic medications for overactive bladder, prompting many clinicians to prescribe β3 adrenergic agonists instead.
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In a retrospective cohort of 830 393 adults, β3 agonist exposure was not associated with a statistically significantly lower dementia incidence than anticholinergic exposure.
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After confounder balancing, regular anticholinergic use was associated with a modestly lower hazard, and longer exposure was not associated with increased dementia risk.
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The authors noted that channeling bias and residual confounding could explain the findings and called for prospective studies with rigorous dementia definitions.

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