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Class of medication used for overactive bladder linked to new onset of dementia


A new study from Western University, Lawson Health Research Institute and ICES provides further evidence of a link between a common class of medications called anticholinergics and the onset of dementia.

Anticholinergic medications are those that act on the body’s cholinergic receptors, and are used to treat a range of conditions from allergies and nausea to overactive bladder and psychiatric disorders.

Using ICES data for more than 60,000 Ontarians, Dr. Blayne Welk looked at a specific group of patients with a condition known as overactive bladder. This condition, which affects one in ten Canadians, can be treated with two different classes of medication – anticholinergic medication, and another medication class known as beta-3 agonists. Both medications are effective for treating overactive bladder.

The results of the study showed an increase in the number of new cases of dementia for patients being treated with an anticholinergic medication compared to those being treated with beta-3 agonists. While the overall risk for dementia was low, the rate was 20 per cent higher for patients treated with an anticholinergic medication. During the study, 2.3% of people developed dementia if they used an anticholinergic, as compared to 1.6% of people who used a beta-3 agonist medication.

“The unique thing about this study is that with overactive bladder there is a new medication that isn’t an anticholinergic, so it allowed us to do a very good comparison between two groups of patients that all have the same condition at the start of the study,” said Dr. Welk, an associate professor at the Schulich School of Medicine & Dentistry at Western and scientist at Lawson Health Research Institute. “We were able to confirm with more certainty that there is an increased risk of dementia with the use of anticholinergic medication.”

Dr. Welk hopes this study will help to further emphasize the cognitive risks associated with this class of drugs, and to encourage physicians to consider alternative medications or appropriate deprescribing where possible.

“The hope is to draw attention from the medical community to consider the cognitive side-effects when prescribing anticholinergic medications,” Dr. Welk, who is also an adjunct scientist at ICES said. “With overactive bladder, we have an alternate medication choice now that works through a different pathway. If a patient has cognitive dysfunction, it may be appropriate to consider using a non-anticholinergic medication first for the treatment of overactive bladder symptoms.”


Crystal Mackay
Media Relations Officer
Schulich School of Medicine & Dentistry
Western University
t. 519.661.2111 ext. 80387, c. 519.933.5944
[email protected]

Deborah Creatura
Media Advisor
[email protected]


Western University delivers an academic experience second to none. Since 1878, The Western Experience has combined academic excellence with life-long opportunities for intellectual, social and cultural growth in order to better serve our communities. Our research excellence expands knowledge and drives discovery with real-world application. Western attracts individuals with a broad worldview, seeking to study, influence and lead in the international community.


The Schulich School of Medicine & Dentistry at Western University is one of Canada’s preeminent medical and dental schools. Established in 1881, it was one of the founding schools of Western University and is known for being the birthplace of family medicine in Canada. For more than 130 years, the School has demonstrated a commitment to academic excellence and a passion for scientific discovery.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

As the research institute of London Health Sciences Centre and St. Joseph’s Healthcare London, and working in partnership with Western University, Lawson Health Research Institute is committed to furthering scientific knowledge to advance healthcare around the world.


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