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Medication burden and frailty in older adults with intellectual disability: An observational cross‐sectional study
Author(s) -
O'Connell Juliette,
Henman Martin C.,
McMahon Niamh,
Burke Éilish,
McCallion Philip,
McCarron Mary,
O'Dwyer Máire
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4987
Subject(s) - medicine , polypharmacy , anticholinergic , geriatrics , odds ratio , sedative , observational study , gerontology , confidence interval , beers criteria , frailty syndrome , pharmacoepidemiology , cross sectional study , psychiatry , medical prescription , frailty index , pathology , pharmacology
Abstract Purpose Recently, efforts have been made to quantify frailty among older adults with intellectual disability (ID). Medication exposure is associated with frailty among older adults without ID. However, there is little research on this association among older adults with ID. The aim of this study was to examine specifically in people with ID the association between frailty and medication exposure, including anticholinergic and sedative medication exposure. Methods Data were drawn from Wave 2 (2013/2014) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA), a nationally representative study of older adults with ID in Ireland. A modified version of Fried's frailty phenotype was constructed. Drug burden measures were polypharmacy, Drug Burden Index (DBI), Anticholinergic Cognitive Burden (ACB) and Sedative Load Model. Multinomial logistic regression was used to calculate odds ratios (ORs) and identify associations between frailty and drug burden. Results This study included 570 participants with ID. Excessive polypharmacy (use of ≥10 medications) was significantly associated with being pre‐frail ( P = .017; OR = 2.56; 95% confidence interval [CI] 1.19‐5.50) and frail ( P < .001; OR 7.13; 95% CI 2.81‐18.12), but DBI, ACB or Sedative Load score were not significantly associated with frailty status ( P > .05). Conclusions This is the first study to examine frailty and its association with medication use including anticholinergic and sedative medication burden among older adults with ID. Further research is required to investigate frailty as measured by other frailty models in relation to medication burden in older adults with ID.