Overactive Bladder Pills and Dementia Risk: What the Studies Show

Several common pills for overactive bladder, the sudden “gotta go” and urge leaks, belong to a group called anticholinergics or antimuscarinics. These medicines are known to cause short-term effects on thinking in some people.¹ Researchers have asked whether long-term use is linked to dementia.

What large studies found

England, 2019. Researchers compared nearly 59,000 people aged 55 and older who were diagnosed with dementia with about 226,000 similar people without it. They looked at prescriptions for 56 strongly anticholinergic medicines over the previous 1 to 11 years.¹

• The more anticholinergic medicine people had taken, the higher the odds of dementia.¹
• Bladder antimuscarinics were among the medicine types linked to higher risk, along with some antidepressants, antipsychotics and seizure medicines.¹
• The links were stronger in people diagnosed before age 80.¹

Japan, 2023. A study of more than 66,000 people 65 and older with dementia and about 329,000 controls found a similar link, including for bladder antimuscarinics.²

What it doesn’t prove

These were case-control studies that compared prescription records. They show an association, not proof that the medicines cause dementia. Still, the 2019 authors concluded it’s important to reduce anticholinergic exposure in middle-aged and older adults, and the 2023 authors said the risks should be weighed against the benefits.¹²

What this means for you

• Don’t stop a bladder medicine on your own. Talk to your prescriber first.
• Ask about your total anticholinergic load. Several other medicines, including some sleep aids and antidepressants, add up.¹
• Ask about other approaches, such as bladder training, pelvic floor therapy, medicines that work differently, and procedures. Our guides to beta-3 agonists, bladder Botox and nerve stimulation cover those options.
• Over-the-counter patches count too. Our article on the oxybutynin patch explains it.

Questions for your clinician or pharmacist

1. Is my bladder medicine an anticholinergic?
2. What else am I taking that adds to that effect?
3. Would a different medicine or approach work for me?
4. How will we check whether it’s still needed?

Try: “I’m 62 and have taken a bladder pill for years. I’ve read about anticholinergics and dementia. Can we review my medicines and talk about alternatives?”

Laugh, Sneeze, Jump includes an appointment prep sheet. Use it to list every medicine and supplement you take and how your bladder symptoms affect you.