Bladder Antimuscarinic Use and Cognitive Impairment in Adults Aged 75 Years or Older With Urinary Incontinence or...

To examine associations of current bladder antimuscarinic use with cognitive impairment in adults aged ≥ 75 years with urinary symptoms.

We analyzed National Health and Nutrition Examination Survey 2011-2014 data. Current use was identified from medications reported during the previous 30 days. Cognitive impairment was defined as CERAD delayed recall < 5, animal fluency < 14, or digit symbol substitution test < 34 among available tests. Survey-weighted logistic models estimated overall and age-specific odds ratios (ORs); the primary model included demographic factors and KDM biological age acceleration. Missing KDM data were multiply imputed.

Among 537 participants representing 8 735 786 US adults, 34 reported current use and 375 met the cognitive-impairment definition (weighted prevalence, 62.5%). The primary overall OR was 2.18 (95% confidence interval [CI], 0.93-5.07; p = 0.069). The use-by-age interaction was imprecise (interaction OR, 0.21; 95% CI, 0.03-1.33; p = 0.093). Among adults aged 75-79 years, 10 of 12 users and 130 of 210 nonusers were impaired (weighted, 82.03% vs. 52.37%); the adjusted OR was 7.18 (95% CI, 1.11-46.40; p = 0.039). Among adults in the public-use group ≥ 80 years, the OR was 1.18 (95% CI, 0.44-3.12; p = 0.733).

The overall estimate was positive but imprecise, and the age-specific contrast rested on sparse exposure. Because NHANES lacks prior-use and discontinuation histories, results may reflect prescribing selection and do not support causal or age-threshold treatment inferences.