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Association of anticholinergic burden with adverse effects in older people with intellectual disabilities: an observational cross-sectional study

  • Máire O'Dwyer (a1), Ian D. Maidment (a2), Kathleen Bennett (a3), Jure Peklar (a4), Niamh Mulryan (a5), Philip McCallion (a6), Mary McCarron (a7) and Martin C. Henman (a8)...
Abstract
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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Copyright
Corresponding author
Máire O'Dwyer, IDS-TILDA, School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College, Dublin 2, Ireland. Email: modwyer6@tcd.ie
Footnotes
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This research was funded by the Department of Health in Ireland and managed by the Health Research Board. The lead author (M.O.'D.) received funding for a PhD from the Trinity College Dublin Studentship. The funding body did not play a role in the study design or writing of the manuscript. The views expressed are those of the authors and are not necessarily those of the Department of Health, the Health Research Board or Trinity College Dublin.

Declaration of interest

None.

Footnotes
References
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Association of anticholinergic burden with adverse effects in older people with intellectual disabilities: an observational cross-sectional study

  • Máire O'Dwyer (a1), Ian D. Maidment (a2), Kathleen Bennett (a3), Jure Peklar (a4), Niamh Mulryan (a5), Philip McCallion (a6), Mary McCarron (a7) and Martin C. Henman (a8)...
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