Why am I not surprised? A study has shown that two classes of drugs often given, in tandem, to people with dementia - a population that also tends to have problems with incontinence - are together causing more rapid functional decline.
In "Dual Treatment of Incontinence and Dementia Associated with Functional Decline," a study from researchers at Wake Forest University School of Medicine, shows that "The two drugs are pharmacological opposites, which led us to hypothesize that the simultaneous treatment of dementia and incontinence could lead to reduced effectiveness of one or both drugs."
The study also says evidence shows "more rapid decline among residents taking both types of drugs represents a significant public health problem because an estimated 33 percent of people with dementia also take a drug for incontinence."
Prescription drugs often save lives. Many dramatically improve quality of life, for some people. However, these little pills - pills looking no more dangerous than a breath mint - have powerful effects on our body's chemistry. That's why they are developed. That's why they work.
However, that is also why, when many different drugs are ingested by one person, the chance of interactions, cancellation of benefits, or other illness, increases.
Most any doctor who treats elders will find many elders come in with prescriptions they have been taking for years; prescriptions from different pharmacies, different doctors. Many doctors have taken elders off all medications (slowly), and found they had medicines treating side effects of other medicines. The elder ends up only needing one or two medications, and actually feels much better.
This situation with drugs for dementia and incontinence is a bit different, in that the doctors know that the patient is on these two types of drugs. Makes sense, right? Medicate for dementia. Medicate for incontinence. However, when the drugs cancel out each other, leaving nothing but side effects, or even cause further decline as this study suggests, we need to take a step back.
Drugs need to be considered from all angles - not just for what they can do to help, but what they can do to harm. Decisions must be made on doing the most good with the least harm.
Fortunately, some newer drugs for incontinence have lately come onboard. Hopefully, doctors who have patients on dementia drugs, and some of the older incontinence drugs, will take a second look. Maybe it's time to reconsider what medications are being given.
This situation underscores the need for physicians to go over, on a regular basis, all medications being given to their patients. This is particularly important for elders with dementia. When a patient can't conclude for him or herself that something is amiss, physicians and families have to be extra vigilant.