It is also interesting to note that CNS medication, anticholinergic and diuretic use were not
statistically associated with incident urinary incontinence. This contrasts with other work
from our group in which CNS drug use increased the risk of two other important geriatric
syndromes, recurrent falls and cognitive impairment.16,17 Although drug-induced urinary
incontinence is biologically plausible with diuretic use due to polyuria, we were not able to
demonstrate an increased risk in the present study.4 While it is possible that participants
receiving diuretics could have had urinary frequency side effects leading to discontinuation
prior to year 3, it was reassuring that past use was not shown to be protective. The lack of
finding with current or past anticholinergic use is also notable. The use of anticholinergics is
a two edge sword for urinary incontinence. By decreasing detrusor overactivity (also known
as overactive bladder), such agents may improve urge urinary incontinence whereas for
patients with detrusor weakness, with or without detrusor overactivity, chronic retention of
urine with associated urinary incontinence may be provoked. Our definition of
anticholinergic did not include psychotropics with anticholinergic properties (included in the
CNS drug use variable). Post hoc sensitivity analyses found that the use of anticholinergic psychotropics, as defined by Rudolph et al., was not statistically significantly associated
with urinary incontinence in the 40 individuals using this class of drugs (OR=1.68, 95% CI=
0.81–3.51, p=0.17). 26 It is important to note though that the point estimate is greater than
one and may be suggestive of the true magnitude of the association.