Tough choice, isn't it? But some commonly used incontinence drugs may cause memory problems in some older people, according to a new study. "Our message is to be careful when using these medicines," US Navy neurologist Jack Tsao, the lead author, tells theAssociated Press. "It may be better to use diapers and be able to think clearly than the other way around."
The research began after Tsao met a 73-year-old patient who, shortly after starting an incontinence drug, began hallucinating conversations with dead relatives and having memory problems. Her thinking improved when she stopped the drug for several months. Aware of similar reports, Tsao and his colleagues looked at a large group of people to measure the effect of these and other med have on acetylcholine, a chemical messenger that shuttles signals through the brain and the rest of the nervous system, the AP writes. The drugs block some nerve impulses, such as spasms of the bladder.
The findings, which were released at a meeting of the American Academy of Neurology, come from an analysis of the medication use and cognitive test scores of 870 older Catholic priests, nuns and brothers who participated in the Religious Orders Study at Chicago's Rush University Medical Center. The average age was 75. Researchers tracked them for nearly eight years, testing yearly for cognitive decline. They asked them to recite strings of numbers backward and forward, to name as many different kinds of fruit as they could in one minute and to complete other challenges, the AP writes.
Nearly 80 percent of the participants took one or more of a class of drugs called anticholinergics, including drugs for high blood pressure, asthma, Parkinson's disease and incontinence drugs such as Detrol and Ditropan. The people who took the drugs had a 50 percent faster rate of cognitive decline compared to those who didn't take any drug. The researchers considered other risk factors for memory loss, such as age, and still found the link, but found no increased risk for Alzheimer's in people taking the drugs.
The incontinence drugs were among the most potent and were the most frequently taken of all the anticholinergics in the study. That's why the researchers believe they are driving the memory problems, Tsao tells the AP.
US sales of prescription drugs to treat urinary problems topped $3 billion in 2007, according to IMS Health. Bladder control trouble affects about one in 10 people age 65 and older, according to the National Institute on Aging, which helped fund the study. Women are more likely to be affected than men. Causes include nerve damage, loss of muscle tone or, in men, enlarged prostate, the AP notes.
Some experts said the research supports previous observations and is helpful because it measures the size of the effect. "This paper adds important new data to the picture," Elaine Perry of Newcastle University in England, who has done similar research but was not involved in the new study, tells the AP.
More research is needed on the effects of anticholinergic drugs on memory, Tsao tells the AP, but adds that docs should do baseline cognitive testing on patients before prescribing the drugs.
An exec at Pfizer, which makes Detrol, says patients should always talk to their docs about problems while taking medication. "Detrol has been on the market since 1998. It has been prescribed more than 100 million times worldwide," Ponni Subbiah, Pfizer's vp of medical affairs, in an e-mail to the AP. Confusion and memory impairment were added to Detrol prescribing info in 2006, Subbiah adds, after some patients reported the problems. Since the reports weren't part of a medical study, "the frequency of events and the role of Detrol in their causation cannot be reliably determined," he writes.
Source: The Associated Press