These medications can contribute to cognitive side effects, including an increased dementia risk with long-term use, as noted in studies like the 2015 JAMA Internal Medicine study (Gray et al.). Oxybutynin is particularly high-risk. Alternatives like beta-3 agonists (e.g., mirabegron/Myrbetriq) or behavioral therapies (e.g., bladder training) may be safer options if cognitive risks are a concern.