Brief ReportsCognitive, Behavioral, and Physiological Changes in Alzheimer Disease Patients as a Function of Incontinence Medications
Section snippets
Subjects
Inclusion criteria were the following: 1) diagnosis of AD; 2) Mini-Mental State Exam (MMSE) score of 10–26, inclusive; 3) required treatment for incontinence with either oxybutynin chloride or tolterodine for a minimum of 4 weeks; 4) hearing, vision, and English comprehension adequate for testing; and 5) a responsible caregiver who could accompany the subject to the evaluations. Exclusion criteria included the following: 1) regular use of antipsychotics, narcotic analgesics, or sedatives; 2)
Baseline Characteristics
A total of 12 subjects fulfilled eligibility criteria and completed the study. However, the data of three subjects were excluded because of technical difficulties in processing the serum assay. The analysis of the Activities of Daily Living Scale, Caregiver Burden Scale, and Memory and Behavior Checklist includes only eight subjects because one caregiver did not complete all caregiver assessments. The study sample consisted of two men and seven women, with a mean age of 78.22 years (standard
DISCUSSION
The purpose of this study was to examine whether patients with AD showed worsening of disease-related deficits as a function of being on incontinence medications with anticholinergic properties. Although the sample size was small, the findings provide preliminary evidence that, when taken off incontinence medications, patients showed better performance on tests of mental status (as assessed by the MMSE) and behavior. Six of nine patients had higher scores on the MMSE and seven of eight patients
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This study was funded by a grant from Emory University, Nell Hodgson Woodruff School of Nursing. The authors thank the Emory University Alzheimer's Disease Center (AG10130) and the Geriatric Medicine Incontinence Clinic at the Wesley Woods Center at Emory University.