What safe bladder medications suit dementia patients at 80?

Question

Hello doctor,

My 81-year-old mother has early dementia and recently started having frequent urinary accidents. Her doctor said it is an overactive bladder and prescribed Oxybutynin. Since then, she has been more confused and sleepy.

Are there bladder medications that are safer in dementia patients?
Would pelvic floor therapy help even at her age?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

We are really sorry about this experience with your mother, and we truly appreciate you reaching out on her behalf. It is completely understandable to feel concerned when a prescribed medication seems to be affecting her cognition and alertness.

There are certain categories of drugs which affect patients of dementia, and any change in behavior or increase in confusion after being prescribed a new drug should not be ignored and reported to their treating doctors immediately.

Overactive bladder is one of the known indications for antimuscarinics like Oxybutynin. However, in elderly patients with dementia, this class of medication can sometimes worsen cognitive symptoms due to its anticholinergic properties, which is likely what you are observing in your mother.

Dealing with overactive bladder in dementia patients requires careful consideration that will involve both her physicians (urologist and geriatrician) and her caregivers working closely together as a team.

Alternative options like Mirabegron (beta-adrenergic agonist) could be explored. It relaxes bladder muscles and could be used for patients with an overactive bladder.

Also, the role of the caregiver in adequate fluid management and a timely toileting schedule cannot be overemphasized.

I hope it helps.

For further queries, you can consult me.

Thank you.