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Mirabegron is recognized for having a low Anticholinergic Cognitive Burden (ACB) score when it comes to treating urinary incontinence. This is significant because anticholinergic medications can have various side effects, particularly in older adults, including confusion and cognitive decline. Mirabegron acts as a beta-3 adrenergic agonist, which means it works by relaxing the bladder muscle to increase storage capacity and reduce urge incontinence without exerting anticholinergic effects that are typical of many other urinary incontinence treatments. This property makes it a safer option for patients, particularly the elderly, who may be more vulnerable to the cognitive side effects associated with anticholinergic drugs.

In contrast, drugs like oxybutynin, fesoterodine, and darifenacin, while effective for managing urinary incontinence, can carry higher ACB scores, indicating a greater potential for cognitive side effects due to their anticholinergic properties. By choosing mirabegron, healthcare providers can manage urinary symptoms while minimizing the risk of cognitive issues in patients.