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Kim YJ, Tae BS, Bae JH. Cognitive Function and Urologic Medications for Lower Urinary Tract Symptoms. Int Neurourol J. 2020;24(3):231-240doi: 10.5213/inj.2040082.041.
Kim, Y. J., Tae, B. S., & Bae, J. H. (2020). Cognitive Function and Urologic Medications for Lower Urinary Tract Symptoms. International neurourology journal, 24(3), 231-240. https://doi.org/10.5213/inj.2040082.041
Kim, Yeon Joo, et al. "Cognitive Function and Urologic Medications for Lower Urinary Tract Symptoms." International neurourology journal vol. 24,3 (2020): 231-240. doi: https://doi.org/10.5213/inj.2040082.041
Kim YJ, Tae BS, Bae JH. Cognitive Function and Urologic Medications for Lower Urinary Tract Symptoms. Int Neurourol J. 2020 Sep;24(3):231-240. doi: 10.5213/inj.2040082.041. Epub 2020 Sep 30. PMID: 33017894; PMCID: PMC7538292.
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Int Neurourol J. 2020 Sep;24(3):231-240. doi: 10.5213/inj.2040082.041. Epub 2020 Sep 30.

Cognitive Function and Urologic Medications for Lower Urinary Tract Symptoms.

International neurourology journal

Yeon Joo Kim, Bum Sik Tae, Jae Hyun Bae

Affiliations

  1. Department of Urology, Daegu Fatima Hospital, Daegu, Korea.
  2. Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

PMID: 33017894 PMCID: PMC7538292 DOI: 10.5213/inj.2040082.041

Abstract

Special considerations should be made when selecting medications for the treatment of lower urinary tract symptoms (LUTS) in older patients especially those over 65 years old. This review summarizes the relationship between current treatments for LUTS and cognitive impairment. Although the recently reported association between dementia and tamsulosin is debatable, the effects of α-blockers and pharmacokinetics are not reported in this context. Five-alpha reductase inhibitors appear to affect mood. However, the association between the development of dementia and cognitive impairment is unlikely. Anticholinergic agents, other than trospium, fesoterodine, and imdafenacin have a relatively high distribution in the central nervous system. In particular, oxybutynin is reported to cause cognitive impairment. Several animal studies on the blood-brain barrier permeability of oxybutynin support this. Therefore, care must be taken when they are used in older patients (65 years and older). Beta-3 agonists are an alternative to, or may be used in combination with, anticholinergic drugs for patients with an overactive bladder (OAB). Several phase 2 and 3 clinical studies report high tolerability and efficacy, making them relatively safe for OAB treatment. However, there is a possibility that cognitive function may be affected; thus, long-term study data are required. We have reviewed studies investigating the correlation of urologic medications with cognitive dysfunction and have provided an overview of drug selection, as well as other considerations in older patients (65 years and older) with LUTS. This narrative review has focused primarily on articles indexed in PubMed, Google Scholar, Scopus, and Embase databases. No formal search strategy was used, and no meta-analysis of data was performed.

Keywords: 5-Alpha reductase inhibitors; Adrenergic alpha-antagonists; Adrenergic beta-3 agonists; Cholinergic antagonists; Cognitive dysfunction; Dementia

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