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Anti-cholinergic medications for bladder dysfunction worsen cognition in persons with multiple sclerosis
Sarah A Morrow1, Heather Rosehart2, Alp Sener3
1Department of Clinical Neurological Sciences, Western University, London Health Sciences Center, LHSC-UH, 339 Windermere Rd, London N6A 5A5, ON, Canada.
Journal of the Neurological Sciences
|February 7, 2018
Summary
Anticholinergic medications, used for bladder dysfunction in multiple sclerosis (MS), may negatively impact cognition in persons with MS (PwMS). Controls showed cognitive improvement, while those on medication did not change over 12 weeks.
Area of Science:
- Neuroscience
- Clinical Pharmacology
- Neuroimmunology
Background:
- Bladder dysfunction is prevalent in persons with MS (PwMS), frequently caused by detrusor overactivity.
- Anticholinergic drugs are first-line treatments for MS-related bladder issues.
- Cognitive decline is a known side effect in older adults and dementia patients, but its effect on PwMS is unclear.
Purpose of the Study:
- To investigate the impact of anticholinergic medications on cognitive function in PwMS.
- To compare cognitive changes in PwMS starting anticholinergic treatment versus a matched control group.
Main Methods:
- A prospective, matched-cohort study design.
- Recruitment of PwMS initiating oxybutynin or tolterodine (cases) and age/sex-matched controls.
- Cognitive assessment using the Brief International Cognitive Assessment for MS (BiCAMS) at baseline and 12 weeks.
Main Results:
- Significant differences in cognitive changes were observed between cases and controls over 12 weeks (p<0.001).
- The control group showed cognitive improvement, likely due to practice effects.
- The group taking anticholinergic medications exhibited no significant change in cognitive performance.
Conclusions:
- Anticholinergic medications may negatively affect cognitive function in persons with MS.
- Further research is warranted to confirm these findings and explore underlying mechanisms.
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