THURSDAY, Jan. 13, 2022 (HealthDay News) — There is an increased risk for overactive bladder (OAB) with the cholinesterase inhibitor (ChEI) donepezil versus rivastigmine, according to a study published online Dec. 2 in the Journal of the American Geriatrics Society.

Prajakta P. Masurkar, from the University of Houston in Texas, and colleagues used Medicare claims data (Parts A, B, and D claims dataset from 2013 to 2015) to assess the risk for OAB with individual ChEIs in older adults with dementia. The analysis included 524,975 older adults with dementia who were incident users of ChEIs (80.72 percent used donepezil, 16.41 percent used rivastigmine, and 2.87 percent used galantamine).

The researchers found that overall, OAB diagnosis/antimuscarinic/mirabegron prescription was seen in 5.07 percent of the cohort within six months of ChEI prescription. Donepezil use increased the risk for OAB versus rivastigmine (adjusted hazard ratio, 1.13) when using propensity scores. There was no differential OAB risk between galantamine and rivastigmine.

“The study findings suggest the need to understand and manage medication-related morbidity in older adults with dementia,” the authors write.

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