Evaluation of use and risks associated with bladder antimuscarinics

 
   Lead Investigator:    Daniela Moga
   Institution      :    University of Kentucky
   E-Mail           :    daniela.moga@uky.edu
   Proposal ID      :    336


   Publications:


1  Moga DC, Abner E, Jicha G
   Bladder Antimuscarinics and Cognitive Decline in Elderly Patients Enrolled in the National Alzheimer's Coordinating Center Cohort
   Abstract  Pharmacoepidemiol Drug Saf,23(S1):173-174,2014,

   PUBLISHED



2  Moga DC, Abner E, Jicha G
   Bladder Antimuscarinics Use by Older Women Enrolled in the National Alzheimer's Coordinating Center Cohort
   2014   Abstract  Society for Epidemiologic Research Annual Meeting June 2014, Seattle, WA , 

   ACCEPTED



3  Moga DC, Abner E, Wu Q, Jicha G
   Bladder Antimuscarinics and Cognitive Decline in Elderly Patients Enrolled in the National Alzheimer's Coordinating Center Cohort
   Journal Article  Alzheimers Dement (N Y),1:139-148,2017,PMC5408467

   PUBLISHED





   Proposal Description:
   The use of bladder antimuscarinics (BAM) in elderly patients is controversial as they are not curative and could potentially result in important adverse effects, especially in elderly patients with multiple comorbidities and cognitive impairment. Despite safety questions, BAM are still being prescribed in this population as they are the first-line option for pharmacological treatment for one of the most prevalent and debilitating conditions in this population- urinary incontinence (i.e., urge and mixed) (Hunskaar et al., 2005 Newman, 2006 Andersson, 2004).     We propose a retrospective analysis using the rich data collected in the ongoing National Alzheimer???s Coordinating Center (NACC) cohort study that would allow for longitudinal evaluation of BAM use and their impact on adverse events with important clinical implications in this population.  The data will allow not only for identification of BAM use and outcomes of interest, but also for measurement of important variables to control for (e.g. demographic characteristics, family history, disease history, and other medications).     The specific aims of this proposed study are:  Specific Aim 1: To determine prevalence and incidence of use for different BAM in elderly enrolled in NACC study.  Specific Aim 2: To describe the characteristics of those receiving different BAM (including demographics, baseline disease history, standardized measures of resident cognitive, behavioral, functional and medical stability status, and residence status) and to identify predictors of medication initiation for managing urinary incontinence in this population.  Specific Aim 3: To determine whether initiation of BAM is associated with increased risk of specific adverse events of importance in this population: falls, cognitive impairment, and morphological changes in the brain.