ArticleJournal of intellectual disability research : JIDR2025
Ten-Year Outcomes of Anticholinergic Use Among Older Adults With Intellectual Disability: Findings From the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA).
Article in Journal of intellectual disability research : JIDR, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- A protocol for application of OPTIMA-ID to identify potentially inappropriate prescribing in a cohort of older adults with intellectual disability.HRB open research · 2026Article
- Ten-Year Outcomes of Anticholinergic Use Among Older Adults With Intellectual Disability: Findings From the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA).Journal of intellectual disability research : JIDR · 2025Article
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9 authors.
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Abstract
backgroundPeople with intellectual disability are frequently exposed to medication with anticholinergic activity. In the general population, the long-term exposure to anticholinergics has been associated with declines in both physical and cognitive function. This study aimed to examine anticholinergic exposure longitudinally in a cohort of older adults with intellectual disability (aged 40 years or over).
methodThe study examined individuals with intellectual disability aged 40 and over, who participated at two time points (Waves 1 and 4), 10 years apart, in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). The Anticholinergic Cognitive Burden (ACB) scale was used to quantify anticholinergic exposure. Logistic regression analysis was employed to examine the adverse outcomes reported at time point 2 in relation to ACB scores at time point 1. Models were adjusted for age, gender, level of intellectual disability, residence, epilepsy and polypharmacy.
resultsThe study included 487 participants who provided medication data at both time points. Anticholinergic exposure remained consistent over the studied period, with approximately 30% having no exposure, 40% having mild exposure (ACB = 1-4) and 30% having high exposure (ACB = 5+). Antipsychotic medications contributed the most to the total score at both time points (Wave 1 = 35%, Wave 4 = 37%), with other anticholinergics, antiepileptics and antidepressant medications contributing 10%-16% each. Mild and high ACB scores at time point 1 were significantly associated with a higher risk of falls (odds ratio [OR] = 1.86, 95% CI: 1.03-3.38) and mental health conditions (ACB 1-4; OR = 6.60, 95% CI: 3.69-11.77; ACB 5+, OR = 17.38, 95% CI: 8.97-33.61) and lower OR for reporting dementia/Alzheimer's disease (ACB 1-4; OR = 0.39, 95% CI: 0.15-0.97; ACB 5+; OR = 0.21, 95% CI: 0.07-0.64).
conclusionOlder adults with intellectual disability are exposed to high anticholinergic burden at the two time points, 10 years apart. Being exposed to anticholinergics at Wave 1 is significantly associated with a higher risk of falls and reporting mental health conditions at Wave 4. A review of antipsychotic prescribing practice is urgently needed to reduce the anticholinergic exposure and its adverse outcomes among older adults with intellectual disability.
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