Do you still routinely prescribe anticholinergics for OAB in patients over 70 without baseline cognitive impairment given the concern for dementia in recent studies?

No, except Trospium. Beta-3 agonists are still first line.

In patients >70, I generally favor a β3-agonist first because of the growing observational association between cumulative anticholinergic exposure and dementia.

Anticholinergics are not absolutely contraindicated, but I would avoid chronic oxybutynin and favor a lower CNS-penetrating agent such as tr...

I try very hard not to prescribe anticholinergic medications for OAB in patients over 65 without cognitive impairment. I also ask younger patients if they have a family history of early cognitive decline, and if they do, I encourage them not to start anticholinergics. I do tell all patients that the...

I usually prescribe Trospium for my BPH patients with OAB, which doesn't cross the BBB

A systematic review of 18 studies (5 RCTs, 13 observational) found no cognitive decline in any of the 6 trospium studies, in patients with or without baseline cognitive impairment—contrasting with oxybutynin (decl...