Navigation Links
Dual treatment of incontinence and dementia associated with functional decline

WINSTON-SALEM, N.C. Older nursing home residents who took medications for dementia and incontinence at the same time had a 50 percent faster decline in function than those who were being treated only for dementia, according to a study from researchers at Wake Forest University School of Medicine and colleagues.

It is likely that the oppositional effects of the drugs contributed to the accelerated decline, said Kaycee M. Sink, M.D., M.A.S., lead author. Over a years time, the decline we observed would represent a resident going from requiring only limited assistance in an activity to being completely dependent, or from requiring only supervision to requiring extensive assistance in an activity.

The combination of drugs affected older adults who started out with higher levels of function in activities of daily living such as dressing, personal hygiene, toileting, transferring, bed mobility, eating and being able to get around the unit. The results were published online by the Journal of the American Geriatrics Society and will appear in a future print issue.

The two most common medical conditions among nursing home residents are dementia and urinary incontinence and they often coexist. The study involved 395 nursing home residents in Indiana who were taking medications for both conditions and 3,141 who were taking only a dementia medication.

Residents included in the analysis were age 65 and older and had had at least two consecutive prescriptions for cholinesterase inhibitors, a family of drugs used to treat dementia. Examples include donepezil (Aricept), galantamine (Razadyne), rivastigmine (Exelon), and tacrine (Cognex). These drugs are designed to increase levels of acetylcholine, a chemical that enhances communication between nerve cells in the brain.

About 10 percent of the residents were also taking either oxybutynin or tolterodine, the two most commonly prescribed drugs for urinary incontinence. These drugs are known as anticholinergic agents and are designed to block acetylcholine.

The two drugs are pharmacological opposites, which led us to hypothesize that the simultaneous treatment of dementia and incontinence could lead to reduced effectiveness of one or both drugs, said Sink, an assistant professor of internal medicine-gerontology.

She said the finding of the more rapid decline among residents taking both types of drugs represents a significant public health problem because an estimated 33 percent of people with dementia also take a drug for incontinence.

Until now, the clinical dilemma for managing incontinence and dementia has been largely theoretical. This research suggests it may lead to worse outcomes, which is the opposite intention of therapy for dementia.

The researchers also measured whether the residents taking both drugs also experienced a decline in mental function, but there was no difference between the two groups, possibly because the test was not sensitive enough. Sink said that similar research should be extended to community-dwelling older adults with dementia and that more sensitive measures for cognition should be used. Previous studies have shown that the bladder medications are associated with cognitive decline and that people with dementia are especially sensitive to this side effect.

The results suggest that clinicians should continue to try non-drug management strategies for incontinence before beginning therapy with one of these common drugs, said Sink.

She noted that the study was conducted in 2003 and 2004, before newer incontinence medications were introduced that may have less effect on acetylcholine in the brain.

Contact: Karen Richardson
Wake Forest University Baptist Medical Center

Related medicine news :

1. New treatment effective in counteracting cocaine-induced symptoms
2. New treatment boosts muscle function in myasthenia gravis
3. Broad-based group of physicians calls for improvement in stroke treatment
4. Cranberry Could Juice Up Ovarian Cancer Treatment
5. Non-medicinal treatment touted for pre-schoolers with ADHD
6. Nonmedicinal treatment touted for preschoolers with ADHD
7. U of M study: Early treatment can reverse heart damage
8. Biologic treatment for rheumatoid arthritis and the risk of cancer
9. New Treatment Explored for Cluster Headaches
10. Thailand: Partners Open Free AIDS Treatment Clinic in Renowned AIDS Temple in Lop Buri
11. 4-Star Gen. Barry Mccaffrey, Former U.S. Drug Czar, to Keynote Recovery Happens! Rally for Treatment: Wed., Sept. 5, 11 Am, State Capitol West Steps, Sacramento
Post Your Comments:
(Date:12/1/2015)... ... December 01, 2015 , ... CloudLIMS today announced that ... Business Awards under the New Products and Services category for its innovative product ... management software that helps labs organize data and track samples with storage ...
(Date:12/1/2015)... NY (PRWEB) , ... December 01, 2015 , ... ... non-traumatic limb amputations in the United States. Podiatrists are well aware that psychology-based ... adopt therapeutic behaviors) are often catastrophic contributors to diseases of the diabetic foot. ...
(Date:12/1/2015)... (PRWEB) , ... December 01, 2015 , ... ... their independence is everything. That is why Hollister Incorporated has launched the VaPro ... offer this next product in the VaPro touch free catheter portfolio,” said Michael ...
(Date:12/1/2015)... ... December 01, 2015 , ... ... has been selected as a finalist in this year’s Fierce Innovation Awards: Healthcare ... IT Healthcare was recognized as a finalist in the category of Digital Solutions ...
(Date:12/1/2015)... ... 01, 2015 , ... TCS Healthcare Technologies (TCS), a leading ... arenas, is pleased to announce that VIP Care Services, a Caprock Health Group ... ACUITY Complete Care™ Management to back their collaborative catastrophic case management initiatives. ACUITY ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... 1, 2015 /PRNewswire/ -- Royal Philips  ... an X-ray imaging software that produces high-contrast images for ... use a grid, at the 2015 Radiological Society ... SkyFlow is Philips, first digital imaging solution providing grid-like ... improves clinician,s workflow and supports "first-time-right imaging" by decreasing ...
(Date:12/1/2015)... 1, 2015 A federal court has denied the ... a lawsuit filed by the Pharmaceutical Care Management Association (PCMA) ... a new law that forces employers and consumers to pay ... Arkansas must now defend a law that raises ... and CEO Mark Merritt . --> ...
(Date:12/1/2015)... 2015 --> --> ... Market by Type of Drug (Monoclonal Antibodies, Interferon-Alpha, Interleukins, Vaccines, ... Pipeline Analysis - Global Forecast to 2020", published by MarketsandMarkets, ... 73,529.2 Million by 2020 from USD 40,281.6 Million in 2015, ... Browse 37 market data T ...
Breaking Medicine Technology: