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Reducing the number and dose of anticholinergic and sedative medicines may improve cognitive function and reduce the likelihood of adverse events.
Causes of dementia include Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia, vascular dementia and Parkinson disease.
Antagonism of muscarinic receptors may lead to overflow incontinence, while use of medicines with antipsychotics, anticonvulsants, antidepressants, opioid analgesics and tramadol, and histamine H1 receptor antagonists commonly used for allergic conditions.
Many anticholinergic medicines sedative properties (eg. benzodiazepines, opioids and tricyclic antidepressants) may contribute to functional incontinence.
Even medicines with minor anticholinergic properties may contribute to unwanted central and peripheral adverse events if used in combination with other agents with anticholinergic effects.Dispensing of anticholinergic medicines also increased following initiation of cholinesterase inhibitors.Some of these anticholinergic medicines may have been prescribed to treat the adverse effects of the cholinesterase inhibitor (eg. Patients may benefit from clinicians reviewing the anticholinergic load of their current medicine regimen before initiating cholinesterase inhibitors or memantine, with the aim of minimising or ceasing medicines with anticholinergic properties.Older people with dementia may be particularly susceptible to cognitive impairment associated with anticholinergic and sedative medicines.This impairment may be misattributed to the disease process itself.
Anticholinergic medicines can cause constipation, which can result in urinary retention and urge and overflow incontinence.