A High Anticholinergic Burden Is Independently Associated With Nocturia in Turkish Older Women

Abstract

Objective: This study aimed to examine the relationship between nocturia and anticholinergic burden.

Methods: The female participants aged ≥ 65 years who presented to the outpatient geriatric clinic between November 2022 and January 2025 were retrospectively reviewed. Nocturia was defined as waking up from bed at night for urination at least twice per night. All participants underwent a comprehensive geriatric assessment (CGA). Demographic characteristics, comorbidities, geriatric syndromes, laboratory findings, and CGA parameters were recorded.

Results: Of 422 total patients, nocturia was present in 65.9% of them. Patients with nocturia were older (p = 0.021) and had higher rates of coronary artery disease (p = 0.036) heart failure (p = 0.002), and chronic lung disease (p = 0.046). Recurrent falls (p = 0.005), polypharmacy (p < 0.001), depression (p < 0.001), and lower gait-balance (p = 0.033) and activities of daily living scores (p < 0.001) were more frequent in the nocturia group. The proportion of patients with a high anticholinergic burden (Anticholinergic Cognitive Burden [ACB] score ≥ 3) was significantly higher in those with nocturia (p = 0.024). There was a significant association between high ACB scores and nocturia, independent of age (OR = 1.69; 95% CI: 1.05-2.69; p = 0.028), comorbidities (OR = 1.60; 95% CI: 1.01-2.60; p = 0.048), and laboratory parameters (OR = 1.63; 95% CI: 1.01-2.60; p = 0.046).

Conclusions: Our findings suggest that a higher anticholinergic burden is independently associated with nocturia in older female adults. Clinicians should be alert to anticholinergic burden as a modifiable factor in the management of nocturia in older female patients and consider deprescribing when appropriate.

Keywords: aging; anticholinergic drug burden; comprehensive geriatric assessment; nocturia.