Bibliographic record
Abstract
Introduction: Overactive bladder (OAB) is commonly treated with anticholinergic medications, but concerns about their long-term cognitive effects, particularly dementia, have emerged.While the link between anticholinergics and dementia has been studied in older populations, evidence for younger individuals is limited.This study examined whether OAB anticholinergics are associated with new-onset dementia in individuals under 65, compared to beta-3 agonists.Methods: A retrospective, propensity-weighted cohort study was conducted using Ontario, Canada population-based data.New users of OAB anticholinergics (oxybutynin, solifenacin, tolterodine, trospium, darifenacin, propiverine, fesoterodine) or beta-3 agonist (mirabegron) were identified through the Ontario Drug Benefit database.Patients aged 18-64 without pre-existing dementia were included.Propensity score weighting balanced baseline characteristics.Dementia incidence, defined via validated administrative data, was analyzed using a Fine-Gray sub-distribution hazard model adjusted for age and sex.Results: Among 57 975 patients (48 454 anticholinergic, 9521 beta-3 agonist), the median followup was 5.9 years.Dementia occurred at a rate of 7.8/1000 personyears, with a median diagnosis age of 62 (IQR 56-66).After weighting, no significant difference in dementia risk was observed between anticholinergics and beta-3 agonists (HR 0.99, 95% CI 0.86-1.15,p=0.92).Subgroup analysis of patients ≥48 years also showed no significant difference (HR 1.08, 95% CI 0.93-1.25,p=0.33).Conclusions: The use of OAB anticholinergics was not associated with a significantly increased risk of dementia in individuals under 65 compared to beta-3 agonists.These findings suggest that anticholinergics may remain a viable treatment option for younger patients without an increased cognitive risk.Further research is needed to confirm these findings and explore potential cognitive risks of OAB medications in different age cohorts and populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.485 | 0.134 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".