Table 4. Crude and adjusted odds ratios for dementia by total cumulative use of different anticholinergic drugs and mirabegron for an overactive bladder in patients with dementia and non-dementia controls, 3-16 years before a diagnosis of dementia*.
| Drug treatment and cumulative use of anticholinergic drug (total standardised daily dose) | No (%) of patients (n=170 742) |
No (%) of controls (n=804 385) |
Unadjusted odds ratio (95% CI) | Adjusted odds ratio† (95% CI) |
|---|---|---|---|---|
| Any anticholinergic drug treatment for overactive bladder: | ||||
| No use of anticholinergic drugs to treat overactive bladder | 155 324 (90.97) | 741 016 (92.12) | 1.00 (Reference) | 1.00 (Reference) |
| Use of anticholinergic drugs for overactive bladder | 15 418 (9.03) | 63 369 (7.88) | 1.15 (1.13 to 1.17) | 1.18 (1.16 to 1.20) |
| Darifenacin: | ||||
| None | 170 676 (99.96) | 804 119 (99.97) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 36 (0.02) | 127 (0.02) | 1.34 (0.92 to 1.95) | 1.08 (0.74 to 1.58) |
| 91-365 | 15 (0.01) | 70 (0.01) | 0.99 (0.56 to 1.73) | 0.86 (0.49 to 1.53) |
| 366-1095 | 10 (0.01) | 51 (0.01) | 0.83 (0.41 to 1.67) | 0.79 (0.39 to 1.59) |
| >1095 | 5 (0.00) | 18 (0.00) | 1.39 (0.52 to 3.75) | 1.26 (0.46 to 3.50) |
| Fesoterodine fumarate: | ||||
| None | 170 214 (99.69) | 802 267 (99.74) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 220 (0.13) | 997 (0.12) | 1.02 (0.88 to 1.18) | 0.91 (0.78 to 1.05) |
| 91-365 | 138 (0.08) | 530 (0.07) | 1.24 (1.03 to 1.50) | 1.08 (0.89 to 1.31) |
| 366-1095 | 99 (0.06) | 349 (0.04) | 1.30 (1.04 to 1.63) | 1.09 (0.87 to 1.38) |
| >1095 | 71 (0.04) | 242 (0.03) | 1.36 (1.04 to 1.77) | 1.15 (0.87 to 1.51) |
| Flavoxate hydrochloride: | ||||
| None | 170 249 (99.71) | 802 279 (99.74) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 379 (0.22) | 1675 (0.21) | 1.04 (0.93 to 1.17) | 0.90 (0.81 to 1.01) |
| 91-365 | 62 (0.04) | 256 (0.03) | 1.13 (0.86 to 1.50) | 0.97 (0.73 to 1.28) |
| 366-1095 | 32 (0.02) | 130 (0.02) | 1.15 (0.77 to 1.69) | 1.07 (0.72 to 1.59) |
| >1095 | 20 (0.01) | 45 (0.01) | 2.13 (1.25 to 3.61) | 1.71 (1.00 to 2.96) |
| Oxybutynin hydrochloride: | ||||
| None | 162 790 (95.34) | 771 806 (95.95) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 5210 (3.05) | 22 666 (2.82) | 1.08 (1.04 to 1.11) | 1.04 (1.01 to 1.07) |
| 91-365 | 1393 (0.82) | 5361 (0.67) | 1.21 (1.14 to 1.28) | 1.14 (1.07 to 1.21) |
| 366-1095 | 901 (0.53) | 3031 (0.38) | 1.39 (1.29 to 1.50) | 1.31 (1.21 to 1.42) |
| >1095 | 448 (0.26) | 1521 (0.19) | 1.39 (1.25 to 1.55) | 1.28 (1.15 to 1.43) |
| Propiverine hydrochloride: | ||||
| None | 170 274 (99.73) | 802 660 (99.79) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 241 (0.14) | 974 (0.12) | 1.16 (1.01 to 1.34) | 1.02 (0.88 to 1.18) |
| 91-365 | 92 (0.05) | 305 (0.04) | 1.40 (1.11 to 1.77) | 1.17 (0.92 to 1.49) |
| 366-1095 | 76 (0.04) | 246 (0.03) | 1.47 (1.13 to 1.90) | 1.17 (0.90 to 1.53) |
| >1095 | 59 (0.03) | 200 (0.02) | 1.39 (1.04 to 1.86) | 1.18 (0.87 to 1.59) |
| Solifenacin succinate: | ||||
| None | 165 964 (97.20) | 785 327 (97.63) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 1789 (1.05) | 7910 (0.98) | 1.06 (1.01 to 1.12) | 1.02 (0.97 to 1.08) |
| 91-365 | 1109 (0.65) | 4444 (0.55) | 1.17 (1.10 to 1.25) | 1.11 (1.04 to 1.19) |
| 366-1095 | 952 (0.56) | 3558 (0.44) | 1.25 (1.16 to 1.34) | 1.18 (1.09 to 1.27) |
| >1095 | 928 (0.54) | 3146 (0.39) | 1.39 (1.29 to 1.49) | 1.29 (1.19 to 1.39) |
| Tolterodine tartrate: | ||||
| None | 163 682 (95.87) | 776 205 (96.50) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 3236 (1.90) | 14 051 (1.75) | 1.08 (1.04 to 1.12) | 1.05 (1.01 to 1.09) |
| 91-365 | 1565 (0.92) | 6066 (0.75) | 1.21 (1.15 to 1.28) | 1.15 (1.08 to 1.22) |
| 366-1095 | 1153 (0.68) | 4054 (0.50) | 1.34 (1.25 to 1.43) | 1.27 (1.19 to 1.37) |
| >1095 | 1106 (0.65) | 4009 (0.50) | 1.29 (1.21 to 1.38) | 1.25 (1.17 to 1.34) |
| Trospium chloride: | ||||
| None | 169 224 (99.11) | 798 583 (99.28) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 781 (0.46) | 3292 (0.41) | 1.12 (1.04 to 1.21) | 0.99 (0.91 to 1.07) |
| 91-365 | 356 (0.21) | 1276 (0.16) | 1.31 (1.16 to 1.47) | 1.12 (0.99 to 1.27) |
| 366-1095 | 244 (0.14) | 735 (0.09) | 1.56 (1.35 to 1.80) | 1.31 (1.13 to 1.52) |
| >1095 | 137 (0.08) | 499 (0.06) | 1.27 (1.05 to 1.54) | 1.12 (0.92 to 1.37) |
| Mirabegron (non-anticholinergic drug): | ||||
| None | 170 326 (99.76) | 802 975 (99.82) | 1.00 (Reference) | 1.00 (Reference) |
| 1-90 | 152 (0.09) | 647 (0.08) | 1.08 (0.91 to 1.30) | 0.91 (0.76 to 1.10) |
| 91-365 | 135 (0.08) | 420 (0.05) | 1.46 (1.20 to 1.78) | 1.27 (1.04 to 1.56) |
| 366-1095 | 116 (0.07) | 288 (0.04) | 1.90 (1.53 to 2.36) | 1.62 (1.30 to 2.03) |
| >1095 | 13 (0.01) | 55 (0.01) | 1.10 (0.60 to 2.03) | 0.89 (0.48 to 1.66) |
*
Dementia outcome includes all dementia subtypes.
†
Multivariable model adjusted for ethnic group, patient level of deprivation, smoking status, alcohol consumption, body mass index, records of anxiety, asthma, atrial fibrillation, bipolar disorder, chronic kidney disease, chronic obstructive pulmonary disease, coronary heart disease, depression, Down's syndrome, head injury, heart failure, hyperlipidaemia, hypertension, learning disability, schizophrenia, stroke, subarachnoid haemorrhage, transient ischaemic attack, type 1 diabetes, type 2 diabetes, mean anticholinergic effect of cognition score of other prescribed anticholinergic drugs for conditions other than an overactive bladder, prescription of other commonly prescribed anticholinergic drugs for an overactive bladder (oxybutynin hydrochloride, solifenacin succinate, and tolterodine tartrate); with case-control matching by age, sex, and general practice.
CI, confidence interval.