Large EHR study finds no higher dementia risk with anticholinergics vs beta-3 agonists for OAB
Retrospective · JAMA Netw Open · 2026-11-07. Number 5 in the UrologyWatch Top 5 for November 7, 2026.
Among 830,393 adults newly treated for overactive bladder using Epic Cosmos data, high-risk anticholinergics were associated with a lower hazard of incident dementia than beta-3 agonists (HR 0.90) or low-risk anticholinergics (HR 0.93).
Why it matters: Raises the question about the presumed cognitive safety advantage of beta-3 agonists over anticholinergics for OAB, but is hypothesis generating from registry data lacking randomization and potential confounding by…
Limitation: Retrospective registry data from Epic Cosmos cannot fully account for confounding by indication or differential follow-up time between drug classes.
Source: JAMA Netw Open · PubMed 42993548 · DOI 10.1001/jamanetworkopen.2026.42026
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