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Chapter 22 - Older People

Published online by Cambridge University Press:  07 November 2024

By
Gemma Lewin ,
Elizabeta Mukaetova-Ladinska ,
Rohit Gumber  and
Satheesh K. Gangadharan
Edited by
David M. L. Branford ,
Satheesh K. Gangadharan ,
Mary Barrett  and
Regi T. Alexander
David M. L. Branford
Affiliation:
Independent Pharmacy Consultant
Satheesh K. Gangadharan
Affiliation:
Leicestershire Partnership NHS Trust
Mary Barrett
Affiliation:
Leicestershire Partnership NHS Trust
Regi T. Alexander
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust
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Summary

The life expectancy for people with intellectual disability is increasing due to advances in medical treatment and social care. However, significant discrepancies in life expectancy between people with intellectual disability and the general population remain, and there continues to be scope to close the inequality gap. This was confirmed in the recent 2021 Learning Disability Mortality Review (LeDeR) report. The standardised mortality ratio for people with intellectual disability ranges from 2–5, which draws a comparison against the general population. Those with additional comorbidities such as epilepsy, genetic syndromes, and functional impairments have a lower age of death. The leading causes of death in older adults (at or over 65 years of age) between 2018 and 2021 were reviewed in the 2021 LeDeR report. In comparison to the general population, a higher proportion of deaths in older intellectual disability adults were due to COVID-19 (coronavirus disease), cancers, and influenza or pneumonia. Unsurprisingly, dementia (in particular Alzheimer’s disease), cerebrovascular disease, chronic lower respiratory tract infections, and diseases of the urinary system were more common causes of death in older intellectual disability compared to that reported in their younger counterparts. This chapter explores the various issues associated with medicating older people.

Keywords

frailtyaccelerated ageingpharmacokineticspharmacodynamicspolypharmacySTOMPanticholinergic burden

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Chapter
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The Frith Prescribing Guidelines for People with Intellectual Disability , pp. 321 - 337
Publisher: Cambridge University Press
Print publication year: 2024

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