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Cholinesterase inhibitors (donepezil, rivastigmine and galantamine) may modestly improve cognition via inhibiting the enzyme acetyl cholinesterase.

All medicines with sedative properties – not only those prescribed for intentional sedation – may contribute to an older person's sedative load.Antagonism of muscarinic receptors may lead to overflow incontinence, while use of medicines with antipsychotics, anticonvulsants, antidepressants, opioid analgesics and tramadol, and histamine H1 receptor antagonists commonly used for allergic conditions.Many anticholinergic medicines sedative properties (eg. benzodiazepines, opioids and tricyclic antidepressants) may contribute to functional incontinence.In a retrospective population based cohort study of 44 884 older people with dementia, use of cholinesterase inhibitors was associated with an increased likelihood of receiving an anticholinergic medicine to manage urinary incontinence.Nonpharmacological approaches are recommended as first line treatment.

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