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Medicines with anticholinergic and sedative properties are widely prescribed for older people in Australia.The likelihood that medicines may produce unwanted central anticholinergic effects depends in part on age related and patient specific variability in pharmacokinetic parameters, bloodbrain barrier permeability, degree of cholinergic neuronal degeneration and a patient's baseline cognitive status.The NICE British National Formulary (BNF) sites is only available to users in the UK, Crown Dependencies and British Overseas Territories.If you believe you are seeing this page in error please contact us.In a retrospective population based cohort study of 44 884 older people with dementia, use of cholinesterase inhibitors was associated with an increased likelihood of receiving an anticholinergic medicine to manage urinary incontinence.Nonpharmacological approaches are recommended as first line treatment.

Medicines may contribute to urinary incontinence via agonism of alpha-1- adrenoceptors or nicotinic acid receptors leading to stress incontinence, or antagonism of beta-3- adrenoceptors or agonism of muscarinic receptors leading to urge incontinence.

Anticholinergic medicines can cause constipation, which can result in urinary retention and urge and overflow incontinence.

Cholinesterase inhibitors prescribed for patients with Alzheimer disease have also been associated with urinary incontinence.

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.

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