Study Links Incontinence Drugs With Memory Problems: Detrol & others shuttles signals through the brain and the rest of the nervous system ... Washington Post April 18, 2008

[Guest guest]

An important thing to consider. . . Since passing 65, I'm quizzed at every checkup about incontinence. . . Apparently prescribing medication for incontinence is very common. . . There are better alternatives . .. like exercises.Rogene

Study Links Incontinence Drugs With

Memory Problems By CARLA

K. JOHNSON

The Associated Press

Washington Post Friday, April 18, 2008; 4:42 AM CHICAGO --

Commonly used incontinence drugs may cause memory problems in some older

people, a study has found. "Our message is to be careful when using these

medicines," said U.S. Navy neurologist Dr. 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 with non-drug treatments, he added, so

patients should ask about alternatives. Exercises, biofeedback and keeping to a

schedule of bathroom breaks work for many. U.S. sales of prescription drugs to treat urinary problems topped $3 billion in

2007, according to IMS Health, which tracks drug sales. 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

research began after Tsao met a 73-year-old patient. Shortly after starting an incontinence

drug, she began hallucinating conversations with dead relatives and having

memory problems. Her thinking improved when she stopped the drug for several

months. Tsao and

his colleagues knew of similar reports. They decided to look at a large group

of people to see if they could measure an effect of these and other medications

that affect acetylcholine, a chemical messenger that shuttles signals through

the brain and the rest of the nervous system. The drugs block some nerve

impulses, such as spasms of the bladder. The

findings, released Thursday 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 during the annual testing. Nearly 80

percent of the study 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. The researchers considered other risk

factors for memory loss, such as age, and still found the link. The researchers

found no increased risk for the memory-robbing disorder 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 said. 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," said Dr. Elaine of

Newcastle University in England ,

who has done similar research but was not involved in the new study. More

research is needed on the effects of anticholinergic drugs on memory, Tsao

said. Doctors should do baseline cognitive testing on patients before

prescribing the drugs, he recommended. A

representative of Pfizer Inc., maker of the top-selling Detrol, said patients

should always talk to their doctors about problems while taking medication. "Detrol

has been on the market since 1998. It has been prescribed more than 100 million

times worldwide," said Ponni Subbiah, Pfizer's vice president of medical

affairs, in an e-mail response to questions. Confusion

and memory impairment were added to prescribing information for Detrol in 2006,

Subbiah said, 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 said. ___ On the

Net: American Academy of Neurology: http://www.aan.com/