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Anticholinergic burden in adult and elderly people with intellectual disabilities: Results from an Italian multicenter cross-sectional study.
PLoS One. 2018; 13(10):e0205897.Plos

Abstract

BACKGROUND

Adults and older people with intellectual disabilities (ID) frequently receive anti-cholinergic drugs in chronic use, but no studies in Italy to date have investigated cumulative anticholinergic exposure and factors associated with high anticholinergic burden in this frail population.

AIM

To probe the cumulative exposure to anticholinergics and the demographic, social and clinical factors associated with high exposure.

METHODS

The 2012 updated version of the Anticholinergic Burden Score (ACB) was calculated for a multicentre sample of 276 adult and older people over 40 years with ID and associations with factors assessed.

RESULTS

Overall, antipsychotics, antiepileptics, anxiolytics, and antidepressants were the most frequent classes contributing to the total ACB score. People living in residential care were more likely exposed to high anticholinergic burden (an ACB score of 3+): both community housing (odds ratio [OR] 4.63, 95%CI 1.08-19.95) and nursing home facility ([OR] 9.99, 95%CI 2.32-43.04). There was also a significant association between an ACB score of 3+ and reporting mental health conditions ([OR] 25.56, 95% CI 8.08-80.89) or a neurological disease ([OR] 4.14, 95%CI 1.32-12.94). Neither demographic characteristics (age and gender) nor other clinical conditions (somatic comorbidity, levels and typology of ID) were associated with higher anticholinergic load. A high burden of anticholinergic was significantly more frequent in laxative users (22.6% ACB3+ vs. 5.1% ACB 0) (p = 0.003).

CONCLUSIONS

Psychotropics drugs were the highest contributors to the anticholinergic burden in adult and old age ID, especially in those people living in institutional settings with mental health and/or neurological conditions. High anticholinergic load has shown to be associated with the use of laxatives.

Authors+Show Affiliations

Geriatric Center, Luigi Boni Foundation, Suzzara, Italy. Project DAD (Down Alzheimer Dementia) ANFFAS Trentino Onlus, Trento, Italy.Project DAD (Down Alzheimer Dementia) ANFFAS Trentino Onlus, Trento, Italy.Project DAD (Down Alzheimer Dementia) ANFFAS Trentino Onlus, Trento, Italy.Project DAD (Down Alzheimer Dementia) ANFFAS Trentino Onlus, Trento, Italy.Project DAD (Down Alzheimer Dementia) ANFFAS Trentino Onlus, Trento, Italy.Project DAD (Down Alzheimer Dementia) ANFFAS Trentino Onlus, Trento, Italy.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30379948

Citation

De Vreese, Luc Pieter, et al. "Anticholinergic Burden in Adult and Elderly People With Intellectual Disabilities: Results From an Italian Multicenter Cross-sectional Study." PloS One, vol. 13, no. 10, 2018, pp. e0205897.
De Vreese LP, Mantesso U, De Bastiani E, et al. Anticholinergic burden in adult and elderly people with intellectual disabilities: Results from an Italian multicenter cross-sectional study. PLoS One. 2018;13(10):e0205897.
De Vreese, L. P., Mantesso, U., De Bastiani, E., Marangoni, A., Weger, E., & Gomiero, T. (2018). Anticholinergic burden in adult and elderly people with intellectual disabilities: Results from an Italian multicenter cross-sectional study. PloS One, 13(10), e0205897. https://doi.org/10.1371/journal.pone.0205897
De Vreese LP, et al. Anticholinergic Burden in Adult and Elderly People With Intellectual Disabilities: Results From an Italian Multicenter Cross-sectional Study. PLoS One. 2018;13(10):e0205897. PubMed PMID: 30379948.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anticholinergic burden in adult and elderly people with intellectual disabilities: Results from an Italian multicenter cross-sectional study. AU - De Vreese,Luc Pieter, AU - Mantesso,Ulrico, AU - De Bastiani,Elisa, AU - Marangoni,Annachiara, AU - Weger,Elisabeth, AU - Gomiero,Tiziano, Y1 - 2018/10/31/ PY - 2017/12/27/received PY - 2018/10/03/accepted PY - 2018/11/1/entrez PY - 2018/11/1/pubmed PY - 2019/3/28/medline SP - e0205897 EP - e0205897 JF - PloS one JO - PLoS One VL - 13 IS - 10 N2 - BACKGROUND: Adults and older people with intellectual disabilities (ID) frequently receive anti-cholinergic drugs in chronic use, but no studies in Italy to date have investigated cumulative anticholinergic exposure and factors associated with high anticholinergic burden in this frail population. AIM: To probe the cumulative exposure to anticholinergics and the demographic, social and clinical factors associated with high exposure. METHODS: The 2012 updated version of the Anticholinergic Burden Score (ACB) was calculated for a multicentre sample of 276 adult and older people over 40 years with ID and associations with factors assessed. RESULTS: Overall, antipsychotics, antiepileptics, anxiolytics, and antidepressants were the most frequent classes contributing to the total ACB score. People living in residential care were more likely exposed to high anticholinergic burden (an ACB score of 3+): both community housing (odds ratio [OR] 4.63, 95%CI 1.08-19.95) and nursing home facility ([OR] 9.99, 95%CI 2.32-43.04). There was also a significant association between an ACB score of 3+ and reporting mental health conditions ([OR] 25.56, 95% CI 8.08-80.89) or a neurological disease ([OR] 4.14, 95%CI 1.32-12.94). Neither demographic characteristics (age and gender) nor other clinical conditions (somatic comorbidity, levels and typology of ID) were associated with higher anticholinergic load. A high burden of anticholinergic was significantly more frequent in laxative users (22.6% ACB3+ vs. 5.1% ACB 0) (p = 0.003). CONCLUSIONS: Psychotropics drugs were the highest contributors to the anticholinergic burden in adult and old age ID, especially in those people living in institutional settings with mental health and/or neurological conditions. High anticholinergic load has shown to be associated with the use of laxatives. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/30379948/Anticholinergic_burden_in_adult_and_elderly_people_with_intellectual_disabilities:_Results_from_an_Italian_multicenter_cross_sectional_study_ L2 - https://dx.plos.org/10.1371/journal.pone.0205897 DB - PRIME DP - Unbound Medicine ER -