Association of Anticholinergic burden with adverse effects in older people with Intellectual Disabilities in Ireland: An observational cross-sectional study

Abstract

Background:Older people with intellectual disabilities (ID) receive anticholinergic drugs but no studies to date have investigated cumulative anticholinergic exposure and its effects in adults with ID. Aim: To determine the cumulative exposure to anticholinergics and the factors associated with high exposure. Methods A modified Anticholinergic Cognitive Burden scale (ACB) was calculated for a representative cohort of 736 people over 40 years with intellectual disabilities, and associations with demographic and clinical factors assessed. Results Age over 65 years was associated with higher exposure (ACB 1-4- 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). Day time drowsiness was associated with higher ACB (p<0·001) and chronic constipation reported more frequently (26·6% ACB 5+ vs 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.