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Effect of Trospium Chloride on Cognitive Function in Women Aged 50 and Older: A Randomized Trial

Geller, Elizabeth J. MD; Dumond, Julie B. PharmD, MS; Bowling, J. Michael PhD; Khandelwal, Christine M. DO; Wu, Jennifer M. MD, MPH; Busby-Whitehead, Jan MD; Kaufer, Daniel I. MD

Female Pelvic Medicine & Reconstructive Surgery: March/April 2017 - Volume 23 - Issue 2 - p 118–123
doi: 10.1097/SPV.0000000000000374
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Objectives This study aimed to investigate the effect of trospium chloride on cognitive function in postmenopausal women treated for overactive bladder (OAB).

Methods Randomized double-blind placebo-controlled trial conducted from April 2013 to April 2015. Women aged 50 years or older seeking treatment for OAB were randomized to either trospium chloride XR 60 mg daily or placebo. Baseline cognitive function was assessed via Hopkins Verbal Learning Test-Revised (HVLT-R), Mini Mental Status Exam, Mini Mental Status X, Digit Span, Trails A, Trails B, and Epworth Sleepiness Scale. Cognitive function was reassessed at week 1 and week 4. A priori power analysis determined that 21 subjects were needed per group.

Results Although 59 women were enrolled and randomized (28 trospium and 31 placebo), 45 completed assessment (21 trospium and 24 placebo). Mean age was 68 years, 78% were white, and 44% had previously taken OAB medication. For the primary outcome, there was no difference in HVLT-R total score between trospium and placebo groups at week 4 (P = 0.29). There were also no differences based on the other cognitive tests. There was a correlation between age and the following week-4 tests: HVLT-R total score (r = −0.3, P = 0.02), HVLT-R total recall subscale (r = −0.4, P = 0.007), Trails A (r = 0.4, P = 0.002), and Trails B (r = 0.4, P = 0.004). A linear regression model found that HVLT-R total score decreased by 0.372 points for each increased year of age.

Conclusions In women aged 50 years and older, there were no changes in cognitive function between those taking trospium and placebo. Cognitive function was correlated with age.

There were no differences in cognitive performance between women taking trospium versus placebo for overactive bladder.

From the *Division of Female Pelvic Medicine and Reconstructive Pelvic Surgery; †Eshelman School of Pharmacy; ‡Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; §Inpatient Palliative Medicine, WakeMed Medical Center, Raleigh, NC; Divisions of ∥Geriatric Medicine and ¶Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC.

Reprints: Elizabeth J. Geller, MD, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, CB no. 7570, Chapel Hill, NC 27599. E-mail:

This study was supported by the American Urogynecologic Society Research Foundation Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the grant sponsors.

The authors have declared they have no conflicts of interest.

This research will be an oral poster presentation at the American Urogynecologic Society 37th annual scientific meeting on September 30, 2016.

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