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

Máire O'Dwyer, Ian D. Maidment, Kathleen Bennett, Jure Peklar, Niamh Mulryan, Philip McCallion, Mary McCarron, Martin C. Henman

Research output: Contribution to journalArticle

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.

LanguageEnglish
Pages504-510
Number of pages7
JournalBritish Journal of Psychiatry
Volume209
Issue number6
Early online date22 Sep 2016
DOIs
Publication statusPublished - 1 Dec 2016

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Cholinergic Antagonists
Disabled Persons
Intellectual Disability
Cross-Sectional Studies
Odds Ratio
Constipation
Mental Health
Sleep Stages
Demography

Bibliographical note

This is an author-produced electronic version of an article accepted for publication in the British Journal of Psychiatry. The definitive publisher-authenticated version is available online at http://bjp.rcpsych.org

Cite this

O'Dwyer, Máire ; Maidment, Ian D. ; Bennett, Kathleen ; Peklar, Jure ; Mulryan, Niamh ; McCallion, Philip ; McCarron, Mary ; Henman, Martin C. / Association of anticholinergic burden with adverse effects in older people with intellectual disabilities : an observational cross-sectional study. In: British Journal of Psychiatry. 2016 ; Vol. 209, No. 6. pp. 504-510.
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Association of anticholinergic burden with adverse effects in older people with intellectual disabilities : an observational cross-sectional study. / O'Dwyer, Máire; Maidment, Ian D.; Bennett, Kathleen; Peklar, Jure; Mulryan, Niamh; McCallion, Philip; McCarron, Mary; Henman, Martin C.

In: British Journal of Psychiatry, Vol. 209, No. 6, 01.12.2016, p. 504-510.

Research output: Contribution to journalArticle

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AU - O'Dwyer, Máire

AU - Maidment, Ian D.

AU - Bennett, Kathleen

AU - Peklar, Jure

AU - Mulryan, Niamh

AU - McCallion, Philip

AU - McCarron, Mary

AU - Henman, Martin C.

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N2 - 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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