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

doi:10.1192/bjp.bp.115.173971

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 journal › Article › peer-review

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.

Original language	English
Pages (from-to)	504-510
Number of pages	7
Journal	British Journal of Psychiatry
Volume	209
Issue number	6
Early online date	22 Sept 2016
DOIs	https://doi.org/10.1192/bjp.bp.115.173971
Publication status	Published - 1 Dec 2016

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

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10.1192/bjp.bp.115.173971

Anticholinergic burden adverse effects in older people
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
Accepted author manuscript, 735 KB

http://bjp.rcpsych.org/content/early/2016/09/09/bjp.bp.115.173971

Cite this

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

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.",

author = "M{\'a}ire O'Dwyer and Maidment, {Ian D.} and Kathleen Bennett and Jure Peklar and Niamh Mulryan and Philip McCallion and Mary McCarron and Henman, {Martin C.}",

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T2 - an observational cross-sectional study

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.

N1 - 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

PY - 2016/12/1

Y1 - 2016/12/1

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.

AB - 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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JO - British Journal of Psychiatry

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

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