The two reports from researchers at Wake Forest University School of Medicine support findings released a few weeks ago that anticholinergic drugs -- which treat a variety of diseases and conditions, including acid reflux, Parkinson's disease and urinary incontinence -- may cause older people to lose their thinking skills more quickly than those who don't take the medicines.

Anticholinergic drugs work by stopping acetylcholine, a chemical that enhances communication between nerve cells in the brain, from binding to its receptors in nerve cells.

In the first Wake Forest study, older adults taking anticholinergics became more likely to walk more slowly and to need help in other daily activities.

"These results were true even in older adults who have normal memory and thinking abilities," study author Dr. Kaycee M. Sink said in a prepared statement. "For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function was similar to that of someone three to four years older."

Common anticholinergic medicines cited in the study included the blood pressure medication nifedipine (Adalat or Procardia), the stomach antacid ranitidine (Zantac) and the incontinence medication tolterodine (Detrol).

The findings, which involved more than 3,000 people, average age 78, were scheduled to be presented Saturday at the American Geriatrics Society annual meeting, in Washington, D.C.

In a separate Wake Forest study, published online in April in the Journal of the American Geriatrics Society, Sink found that older nursing home residents who took medicines for dementia along with anticholingerics for incontinence declined in function 50 percent faster than those only treated only for dementia.

"Over a year's time, the decline we observed would represent a resident going from requiring only limited assistance in an activity to being completely dependent, or from requiring only supervision to requiring extensive assistance in an activity," said Sink, an assistant professor of internal medicine-gerontology at Wake Forest.

The seniors in the second study had completed at least two consecutive prescriptions for cholinesterase inhibitors, a family of drugs used to treat dementia by increasing levels of acetylcholine. These include donepezil (brand name Aricept), galantamine (Razadyne), rivastigmine (Exelon) and tacrine (Cognex).

About 10 percent of those studied were also taking either oxybutynin or tolterodine, the two most commonly prescribed drugs for urinary incontinence.

"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, Sink said.

As an estimated 33 percent of people with dementia also take a medicine to control incontinence, this finding is especially alarming.

The two studies suggest that physicians should carefully consider the implications when prescribing anticholingeric medications to older adults.

More information

The U.S. National Institute on Aging has more about older adults and medications.

Frequent urge to urinate, incontinence and dropped pelvic organs are among the symptoms of such disorders.

The study of 4,000 women (80 percent had given birth) found that 25 percent suffered from anal incontinence, 15 percent from stress urinary incontinence, 13 percent from overactive bladder, and 6 percent from dropped pelvic organs (pelvic organ prolapse). The women in the study were aged 25 to 84. The findings were published in the March issue of Obstetrics & Gynecology.

"These conditions really affect a woman's quality of life. Many women think this is just something they have to deal with as they age, and there isn't anything they can do about it, but that's not true," study author Jean M. Lawrence, a research scientist at Kaiser Permanente's department of research and evaluation in southern California.

A previous study by the same team of researchers found that vaginal births double the rate of pelvic floor disorders, compared to Caesarean deliveries or never giving birth.

"One of the myths surrounding pelvic floor disorder is that it affects only older women, but the truth is these conditions are extremely prevalent and extremely debilitating. But because the subject matter isn't cocktail conversation, women feel isolated and don't seek support and treatment," study co-author Dr. Karl Luber, a urogynecologist in the department of obstetrics and gynecology at Kaiser Permanente San Diego Medial Center, said in a prepared statement.

Women with symptoms of pelvic floor disorders should consult with a doctor trained in female pelvic medicine and reconstructive surgery, he advised.

"Among the available options for treatment for these common disorders are physical therapy to strengthen your pelvic floor muscles, devices that can be fit to support your vaginal walls, and surgery. Many of today's surgeries are very noninvasive and can be done as an outpatient," Luber said.

In the United States, more than 15 million women have stress urinary incontinence, 16 million have an overactive bladder, and one in 10 suffers from anal incontinence, according to information in a news release about the study.

More information

The U.S. National Institute of Child Health & Human Development has more about pelvic floor disorders.

The National Women's Health Information Center lists these non-surgical options to help control urinary incontinence:

• Perform Kegel exercises designed to make your pelvic muscles stronger.
• Set a schedule for emptying your bladder, instead of waiting until you have to go. Slowly increase the amount of time between trips to the bathroom.
• Maintain a healthy body weight, as excess weight can strain the bladder and surrounding muscles.
• Limit or avoid beverages that contain caffeine or alcohol.
• Biofeedback may help you learn to better control the bladder and surrounding muscles.
• Prescription medication may help control some types of incontinence. Talk with your doctor about whether medication may work for you.

In 2005, more than 181,000 hysterectomies done in the United States were on Baby Boomers with two common uterine problems -- fibroid tumors and heavy bleeding. But both conditions can often be treated with newer, less-invasive approaches, according to the report commissioned by the National Women's Health Resource Center.

The center describes the report as a first-of-its kind study on the prevalence of pelvic health disorders among American women.

Baby Boomer women, born between 1946 and 1964, are now in the age group where other pelvic disorders, such as stress urinary incontinence and pelvic prolapse, are common. Both stress urinary incontinence and pelvic prolapse, when the pelvic organs shift downward, may be significantly under-diagnosed in American women. That lack of diagnosis may be due to several factors, including lack of awareness or the perceived stigma associated with the conditions, according to the report released Tuesday.

The National Women's Health Resource Center (NWHRC) commissioned the report because there "are so many new treatment options for pelvic disorders available," said Elizabeth Battaglino Cahill, the organization's executive vice president. "What we're finding out is that so many women don't know about" those options, she added.

Cahill said the report found that many women don't report the symptoms of fibroids, heavy bleeding, stress urinary incontinence or pelvic prolapse out of embarrassment or the belief that they are part of the normal course of aging.

She added that the NWHRC wants to make pelvic health the subject of the kind of discussion that's now commonplace for menopause. That way women will become more aware and ask their doctors about newer treatments, she said.

With that in mind, the group is launching a campaign called "What's Going on Down There?" It seeks to educate women how to maintain pelvic health throughout their lives and to provide information about common pelvic conditions and available treatments.

The number of women 40 to 49 years old who are having hysterectomies is a "secret in plain view," added Henrick Harwood, a vice president of the Lewin Group, which prepared the report for the NWHRC. "It's estimated that at least 25 percent of boomers will have a hysterectomy by the age of 60," he said.

What makes Baby Boom women turn to hysterectomies, the same treatment their mothers and grandmothers underwent, when better, newer options are available?

"That's the real question," said Dr. William H. Parker, an obstetrician and gynecologist and clinical professor at the University of California, Los Angeles School of Medicine.

"The numbers still haven't changed," Parker said, despite such surgical advances as myomectomy, which removes the fibroid rather than the entire uterus, and endometrial ablation, which destroys a thin layer of the uterine lining. "It's shocking," he added.

Parker said some women may not turn to the newer treatments, which have a quicker recovery time and preserve the uterus and ovaries, because the doctor who delivered their children and whom they've seen for 20 years recommended a hysterectomy.

Many doctors, Parker added, aren't trained to do the newer surgeries, insurance companies may not reimburse for them, or women may simply not be aware of them.

"A major part of my practice is giving second and third opinions because women are not getting the information they want," Parker said.

There are other factors that may compel women to continue to have unnecessary hysterectomies.

Dr. David Archer, a reproductive endocrinologist at Eastern Virginia Medical School in Norfolk, said endometrial ablation may not always be the cure for heavy bleeding, called menorrhagia. "The improvement in blood loss may not mean no blood loss at all," he explained. He added that, with a hysterectomy, the bleeding stops, so some women may choose that option to get it over with.

The report said an estimated 33 percent of Baby Boom women have stress urinary incontinence, but only about 47 percent of all women have ever asked their doctor about it. Many women don't realize that treatment may be as simple as floor exercises or biofeedback, or that surgical interventions are also available, the report said.

Some statistics show that as many as 40 percent of women between the ages of 50 and 79 have some form of pelvic prolapse, the report added. But only about 10 percent to 20 percent of women seek medical care, which includes surgical and non-surgical treatments, the report added.

More information

To learn more about the report, visit the National Women's Health Resource Center.

SUNDAY, May 20 (HealthDay News) -- Green tea may help protect against bladder inflammation, a new study says.

"We discovered that catechins found in green tea protected both normal and cancerous bladder cells from inflammation when we exposed the cells to hydrogen peroxide," Dr. Michael B. Chancellor, professor of urology and gynecology at the University of Pittsburgh School of Medicine, said in a prepared statement.

"Although further studies are needed, the results indicate herbal supplements from green tea could be a treatment option for various bladder conditions that are caused by injury or inflammation," he said.

In their laboratory study, Chancellor and his colleagues exposed normal and cancerous bladder cells to two major catechin components of green tea -- epigallocatechin gallate (EGCG) and epicatechin gallate (ECG) -- and then exposed the cells to hydrogen peroxide.

Hydrogen peroxide normally damages or kills cells, but EGCG and ECG offered significant protection to the cells. The concentrations of the two kinds of catechins were at levels that can be obtained through normal dietary intake, the researchers said.

The study was to presented Sunday at the annual meeting of the American Urological Association, in Anaheim, Calif.

More information

The U.S. National Center for Complementary and Alternative Medicine has more about green tea.