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Association of anticholinergic burden with adverse effects in older people with intellectual disabilities: an
Máire O'Dwyer1, Ian D Maidment2, Kathleen Bennett2
1Máire O'Dwyer, PhD, School of Pharmacy and Pharmaceutical Sciences and IDS-TILDA School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland; Ian D. Maidment, PhD, School of Life and Health Sciences, Aston University, Birmingham, UK; Kathleen Bennett, PhD, Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James Hospital, Dublin, Ireland; Jure Peklar, MPharm, School of Pharmacy, University of Ljubljana, Ljubljana, Slovenia; Niamh Mulryan, MB MRCPsych, IDS-TILDA School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland; Philip McCallion, PhD, Centre for Aging and Excellence in Community Wellness, University At Albany, New York, USA; Mary McCarron, PhD, Trinity College Dublin, Ireland; Martin C. Henman, PhD, School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Ireland modwyer6@tcd.ie.
Background:
No studies to date have investigated cumulative anticholinergic exposure and its effects in adults with intellectual disabilities.
Aims:
To determine the cumulative exposure to anticholinergics and the factors associated with high exposure.
Method:
A modified Anticholinergic Cognitive Burden (ACB) scale score was calculated for a representative cohort of 736 people over 40 years old with intellectual disabilities, and associations with demographic and clinical factors assessed.
Results:
Age over 65 years was associated with higher exposure (ACB 1-4 odds ratio (OR) = 3.28, 95% CI 1.49-7.28, ACB 5+ OR = 3.08, 95% CI 1.20-7.63), as was a mental health condition (ACB 1-4 OR = 9.79, 95% CI 5.63-17.02, ACB 5+ OR = 23.74, 95% CI 12.29-45.83). Daytime drowsiness was associated with higher ACB (P<0.001) and chronic constipation reported more frequently (26.6% ACB 5+ v. 7.5% ACB 0, P<0.001).
Conclusions:
Older people with intellectual disabilities and with mental health conditions were exposed to high anticholinergic burden. This was associated with daytime dozing and constipation.
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