Study ties incontinence drugs, memory trouble

CHICAGO - Commonly used incontinence drugs may cause memory problems in some older people, researchers reported yesterday.

"Our message is to be careful when using these medicines," said Navy neurologist Jack Tsao, who led the study. "It may be better to use diapers and be able to think clearly than the other way around."

Urinary incontinence sometimes can be resolved without drugs, he added, so patients should ask about alternatives. Exercises, biofeedback, and keeping to a schedule of bathroom breaks often work.

Bladder-control trouble affects about one in 10 people age 65 and older, and U.S. sales of prescription medicines to treat urinary problems topped $3 billion in 2007, according to IMS Health, which tracks drug sales. Women are more likely to be affected than men.

Tsao and his colleagues examined medications that act on acetylcholine, a chemical messenger that shuttles signals through the brain and nervous system. The drugs block some nerve impulses, such as spasms of the bladder.

The findings, presented 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 annually for cognitive decline. They asked the patients to recite strings of numbers backward and forward, to name as many kinds of fruit as they could in one minute, and other challenges.

Nearly 80 percent of the participants took one or more of a class of medicines 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 than those who did not. The researchers considered age and other risk factors for memory loss, and still found the link.

There was no increased risk for Alzheimer's disease.

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 said.

Confusion and memory impairment were added to prescribing information for Pfizer Inc.'s top-selling Detrol in 2006, said Ponni Subbiah, vice president of medical affairs, after some patients reported the problems.