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


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.

Publication DOI:
Divisions: College of Health & Life Sciences
College of Health & Life Sciences > Aston Pharmacy School
College of Health & Life Sciences > Chronic and Communicable Conditions
Additional Information: 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
Uncontrolled Keywords: Psychiatry and Mental health
Publication ISSN: 1472-1465
Last Modified: 06 May 2024 07:16
Date Deposited: 27 Sep 2016 07:45
Full Text Link: http://bjp.rcps ... p.bp.115.173971
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2016-12-01
Published Online Date: 2016-09-22
Accepted Date: 2016-06-12
Authors: O'Dwyer, Máire
Maidment, Ian D. (ORCID Profile 0000-0003-4152-9704)
Bennett, Kathleen
Peklar, Jure
Mulryan, Niamh
McCallion, Philip
McCarron, Mary
Henman, Martin C.



Version: Accepted Version

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