Overactive Bladder and Cognitive Impairment: The American Urogynecologic Society and Pelvic Floor Disorders Research Foundation State-of-the-Science Conference Summary Report

被引：7

作者：

Dengler, Katherine L. ^{[1
]}

High, Rachel A. ^{[2
]}

Moga, Daniela C. ^{[3
]}

Zillioux, Jacqueline ^{[4
]}

Wagg, Adrian ^{[5
]}

DuBeau, Catherine E. ^{[6
]}

Ackenbom, Mary F. ^{[7
,8
]}

Alperin, Marianna ^{[9
]}

Dumoulin, Chantale ^{[10
]}

Birder, Lori A. ^{[11
]}

Mazloomdoost, Donna ^{[12
]}

Lai, H. Henry ^{[13
]}

Sung, Vivian W. ^{[14
]}

Gray, Shelly L. ^{[15
]}

Sanses, Tatiana V. D. ^{[16
]}

机构：

[1] Walter Reed Natl Mil Med Ctr, Bethesda, MD 20814 USA

[2] Univ Texas Austin, Dell Med Sch, Womens Hlth, Austin, TX 78712 USA

[3] Univ Kentucky, Lexington, KY USA

[4] Cleveland Clin, Glickman Urol & Kidney Inst, Cleveland, OH 44106 USA

[5] Univ Alberta, Edmonton, AB, Canada

[6] Dartmouth Hitchcock Med Ctr, Hanover, NH USA

[7] Magee Womens Res Inst, Pittsburgh, PA USA

[8] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA

[9] Univ Calif San Diego, La Jolla, CA 92093 USA

[10] Univ Montreal, Montreal, PQ, Canada

[11] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA

[12] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, NIH, Bethesda, MD USA

[13] Washington Univ, Sch Med, St Louis, MO USA

[14] Brown Univ, Women & Infants Hosp Rhode Isl, Warren Alpert Med Sch, Providence, RI 02912 USA

[15] Univ Washington, Seattle, WA 98195 USA

[16] Howard Univ, Coll Med, Washington, DC USA

来源：

UROGYNECOLOGY | 2023年 / 29卷 / 1S期

基金：

美国国家卫生研究院;

关键词：

BLOOD-BRAIN-BARRIER; MIXED URINARY-INCONTINENCE; CENTRAL-NERVOUS-SYSTEM; ANTICHOLINERGIC MEDICATION USE; ICS JOINT REPORT; OLDER WOMEN; DOUBLE-BLIND; SACRAL NEUROMODULATION; TROSPIUM CHLORIDE; ELDERLY-PEOPLE;

D O I：

10.1097/SPV.0000000000001272

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

ImportanceOveractive bladder (OAB) is prevalent in older adults in whom management is complicated by comorbidities and greater vulnerability to the cognitive effects of antimuscarinic medications.ObjectivesThe aim of this study is to provide a comprehensive evidence-based summary of the 2021 State-of-the-Science (SOS) conference and a multidisciplinary expert literature review on OAB and cognitive impairment.Study DesignThe American Urogynecologic Society and the Pelvic Floor Disorders Research Foundation convened a 3-day collaborative conference. Experts from multidisciplinary fields examined cognitive function, higher neural control of the OAB patient, risk factors for cognitive impairment in older patients, cognitive effects of antimuscarinic medications for OAB treatment, OAB phenotyping, conservative and advanced OAB therapies, and the need for a multidisciplinary approach to person-centered treatment. Translational topics included the blood-brain barrier, purine metabolome, mechanotransduction, and gene therapy for OAB targets.ResultsResearch surrounding OAB treatment efficacy in cognitively impaired individuals is limited. Short- and long-term outcomes regarding antimuscarinic effects on cognition are mixed; however, greater anticholinergic burden and duration of use influence risk. Oxybutynin is most consistently associated with negative cognitive effects in short-term, prospective studies. Although data are limited, beta-adrenergic agonists do not appear to confer the same cognitive risk.ConclusionsThe 2021 SOS summary report provides a comprehensive review of the fundamental, translational, and clinical research on OAB with emphasis on cognitive impairment risks to antimuscarinic medications. Duration of use and antimuscarinic type, specifically oxybutynin when examining OAB treatments, appears to have the most cognitive impact; however, conclusions are limited by the primarily cognitively intact population studied. Given current evidence, it appears prudent to minimize anticholinergic burden by emphasizing nonantimuscarinic therapeutic regimens in the older population and/or those with cognitive impairment.

引用

页码：S1 / S19

页数：19

共 1 条

[1] Evidence-Informed, Interdisciplinary, Multidimensional Action Plan to Advance Overactive Bladder Research and Treatment Initiatives: Directives From State-of-the-Science Conference on Overactive Bladder and Cognitive Impairment
Sanses, Tatiana V. D.
Zillioux, Jacqueline
High, Rachel A.
Dengler, Katherine L.
Ackenbom, Mary F.
DuBeau, Catherine E.
Alperin, Marianna
Wagg, Adrian
Birder, Lori A.
Dumoulin, Chantale
Bavendam, Tamara
[J]. UROGYNECOLOGY, 2023, 29 (1S): : S20 - S39

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