Aging baby boomers are worried about their brainpower. A report in the new England Journal of Medicine (Oct. 6, 2011) notes that three-fourths of people over the age of 60 are concerned about problems with their memory.

Researchers have no clear explanation why memory seems to fade with age. but a recent study from England and Wales suggests that medications may be part of the problem (Journal of the American Geriatrics Society, Aug. 2011). Up to half of the people over the age of 65 were taking one or more drugs that could cause cognitive impairment.

The scientists were especially concerned about medicines that affect the function of the brain chemical acetylcholine. this neurotransmitter is essential for transmitting messages between nerve cells.

A surprising number of medications have anticholinergic activity. These include antidepressants such as amitriptyline, anticonvulsants like carbamazepine and heart drugs such as atenolol, furosemide and nifedipine. There are hundreds of others, including the medicines used to treat overactive bladder, allergy symptoms and anxiety.

Taking such drugs can cause fuzzy thinking, confusion, difficulty reasoning or planning and problems with memory. One reader shared this experience:

“I’m 72 and I have fibromyalgia. I was recently switched from Robaxin to baclofen for muscle spasms.

“I tried baclofen for a few days and realized my mind developed blank spots, like someone used Wite-Out. Two others I know had the same problem. The elderly are apt to be misdiagnosed with dementia due to drugs like this.”

People should never stop taking any prescribed medication without discussing the implications with their doctors. Some of these medicines are crucial for health.

However, the impact of combining several anticholinergic drugs can be devastating. Some people take three or four such medications, increasing the likelihood of cognitive side effects. The British research also found that patients on several anticholinergic medicines were at higher risk of dying prematurely.

It is frequently difficult for physicians to determine how a medication will affect acetylcholine activity and cognitive function in older patients. this kind of information is often left out of publications.

A recent study in the Journal of the American Geriatrics Society (July 2011) evaluated hundreds of studies of medications prescribed for overactive bladder. Three-fourths did not measure or report an impact on brain function. The authors called for more systematic examination of such side effects and better reporting in the medical literature.

Accumulating lots of birthdays can contribute to mental fog and memory problems all by itself. taking medications that have a negative impact on brain function can make the problems worse. Anyone who suspects that a medication could be contributing to confusion or forgetfulness should ask a physician to evaluate this possibility.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. in their column, Joe and Teresa Graedon answer letters from readers. Email them via their Web site.

Overactive bladder is a condition that is also referred to as “urge incontinence” or “spastic bladder”. in most cases, those that are older experience complications associated with this condition. However, it could affect an individual of any age group.

Typically, the sufferer will experience an increased need to urinate when this loss of urine occurs. many individuals believe that an overactive bladder is a medical condition or a disease.

In all actuality, this is simply a symptom of an underlying condition. in this medical guide, you will learn important facts pertaining to the topic of spastic bladder.

The Causes of Urge Incontinence

Medical professionals have established that when an individual experience an overactive bladder, it is a direct result from contractions that occur in the bladder and are considered to be abnormal.

The muscles that assist in the flow and output of the urine contained within the bladder are called sphincter muscles.when an individual experiences an overactive bladder, these muscles are no longer effective when it comes to controlling the urine to be emitted from the body.

Examples of situations that could result in these contractions include the following:

• There are nerves located in the bladder walls as well as around the bladder in the body. If these nerves become damaged for one reason or another, it could result in contractions of the muscles that are considered to be abnormal.

• If there has been an injury or any type of traumatic situation involving the spinal cord, the muscles may contract abnormally.

• It has been established that there are certain types of stimuli that may result in the contraction of the muscles that surround the bladder. For example, many individuals may experience muscle contractions.Risk Factors

There are many risk factors associated with overactive bladder. while individuals from older generations suffer from this medical condition, it could affect any person of any age.

Many women that become pregnant may experience this complication. in the same respect, those that have recently given birth may suffer from a spastic bladder.

Individuals that have had certain surgeries such as those of the prostate and suffer from medical conditions such as diabetes and certain types of injuries may also suffer from overactive bladder. If you feel as if you may suffer from this condition, it is important to seek medical assistance for treatment.

SaturdayNovember 6, 2010 2:00 pm

Several studies have already demonstrated that antichloinergic medications are safe to use in  men with bladder outflow obstruction.  Abrams et al performed urodynamics in men with bladder outflow obstruction before and after commencing anticholinergics (1).  there was no increased risk of urinary retention and no clinically significant change invoiding pressures or residual volumes.  a systematic review and meta-analysis by Blake-James et al confirmed these findings.

In this months BJU Int a futher paper adds evidence to the safety and efficacy of anticholinergics in men with residual overactive symptoms (urgency and frequency) already treated with an alpha blocker.  They also looked to see if Prostate Specific Antigen (PSA) influenced safety and efficacy.  They concluded that the addition of tolterodine-ER (anticholinergic) to alphablocker therapy improved key overactive bladder symptoms and appeared to be well tolerated regardless of subjects prostate size as judged by serum PSA concentrations (3).

(1)  Abrams P et Al.  Safety and tolerability of Tolterodine in the treatment of Overactive bladder in men with Bladder Outflow Obstruction.  J Urol 2006; 175:999-1004.

(2)  Blake-James et al.  the role of anticholinergics in men with LUTS suggestive of BPH: a systematic review and meta-analysis.  BJU Int 2006; 99:85-96.

(3)  Chapple et al.  Efficacy and safety of tolterodine-ER in men with overactive bladder symptoms treated with alpha-blocker:  effect of baseline PSA concentrstion.  BJU Int 2010; 106: 1332-1338.

Posted by: Andrew Sinclair | November 6, 2010 « Requesting a PSA test | News home | PCA3 test may predict prostate cancer occurring in the future »