Background: Studies have shown an association between lower urinary tract symptoms (LUTS) and an increased risk of dementia. Whether anticholinergic use contributes to the development of dementia in patients with LUTS remains unknown, especially in Asian populations. This study aims to investigate the association between anticholinergic use and dementia in patients with LUTS.Methods: This study included patients aged 50 years and over with newly diagnosed LUTS (January 2001 to December 2005), divided into four groups according to their cumulative defined daily doses (cDDDs) of anticholinergics: < 28 cDDDs, 28–84 cDDDs, 85–336 cDDDs, ≥337 cDDDs. Patients were followed up until dementia developed or until the end of 2012.Results: We recruited a total of 16,412 patients. The incidence of dementia was 10% in the < 28 cDDD group, 8.9% in the 28–84 cDDD group, 11.5% in the 85–336 cDDD group, and 14.4% in the ≥337 cDDD group (p = .005). In a Cox proportional hazards analysis, the adjusted hazard ratio of dementia was 1.15 (95% CI = 0.97–1.37) in the 85–336 cDDD group, and 1.40 (95% CI = 1.12–1.75) in the ≥337 cDDD group after adjusting for covariates.Conclusions: Our study indicates that higher cumulative anticholinergic exposure is associated with an increase in the risk of incident dementia in patients with LUTS aged 50 years of age and over. Either using one anticholinergic agent or switching anticholinergic agents cumulatively increases this risk. Therapeutic risks and benefits of using anticholinergics in LUTS treatment should be clinically reviewed and weighed.
1 January 2020 in Journal of Minimally Invasive Gynecology
Limited information is available concerning investigating the separate effect of teenage childbirth on medical issues in the antenatal and perinatal periods. Therefore, this study aimed to assess medical problems in antenatal and perinatal periods among early youth, adolescent and young adult mothers in Taiwan. This retrospective population-based cohort study was conducted by using data from Taiwan’s National Health Insurance Research Database. A total of 335,590 mothers aged less than 25 years who had singleton births were identified between 2002 and 2011. Univariate and multivariate logistic regression analyses were conducted to estimate unadjusted and adjusted odds ratios (OR) and 95% confidence intervals (CI) of each medical problem category in the antenatal and perinatal periods. Compared with mothers aged 20–24 years, adolescents (16–19 years) and early youth mothers (≤15 years), particularly those aged 10–15, had a significantly higher risk of intrauterine growth retardation (IUGR, OR = 1.37, 95% CI: 1.00–1.89) and preterm delivery (OR = 2.98, 95% CI: 2.48–3.58) after adjusting for demographic characteristics and clinical factors. Additionally, adolescents mothers were at an increased risk of anemia (OR = 1.32, 95% CI: 1.24–1.40), oligohydramnios (OR = 1.21, 95% CI: 1.12–1.32), failed labor induction (OR = 1.33, 95% CI: 1.24–1.43), and fetal distress (OR = 1.20, 95% CI: 1.14–1.26) after adjustment. Not all young mothers in our study experienced the same magnitude of increased medical problems in the antenatal and perinatal periods. However, a sufficiently higher probability of having IUGR and preterm delivery was observed among early youth and adolescent mothers.
Background: Bodily pain is a common condition in older adults and interferes with individuals’ cognitive functioning. We aimed to evaluate the association between bodily pain and related locations and cognitive impairment among community-dwelling older adults in Taiwan. Method: In this retrospective, cross-sectional study, we enrolled 2022 participants aged 60‒70 years, from the Taiwan Biobank. Mini-Mental State Examination was performed to assess cognitive impairment. Further, logistic regression analyses were performed to identify the relationship between bodily pain and cognitive impairment. Results: Overall, 161 participants had cognitive impairment. Multivariable analysis showed that older adults who reported bodily pain were more likely than those who did not have cognitive impairment (odds ratio 1.68). Moreover, the occurrence of cognitive impairment correlated with the presence of two or more pain locations and self-reported low back and waist pain or sciatica. Conclusion: Our study revealed that cognitive impairment was associated with bodily pain in community-dwelling older adults, particularly older adults with low back and waist pain or sciatica and those with two or more pain locations. To maintain the quality of older adults’ life, pain and cognitive decline need to be simultaneously assessed with considerably more precise and objective markers.
28 December 2020 in American Journal of Cardiovascular Drugs