School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
Pharmacoepidemiol Drug Saf. 2020 Apr;29(4):482-492. doi: 10.1002/pds.4987. Epub 2020 Mar 5.
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.
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.
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).
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.
最近，人们努力对智力障碍（ID）老年人的衰弱情况进行量化。药物暴露与无 ID 的老年人的衰弱有关。然而，关于 ID 老年人的这种关联的研究很少。本研究的目的是专门研究 ID 人群中衰弱与药物暴露之间的关系，包括抗胆碱能药物和镇静药物暴露。
数据来自爱尔兰老龄化纵向研究（IDS-TILDA）的智力障碍补充部分的第 2 波（2013/2014 年），这是一项对爱尔兰 ID 老年人的全国代表性研究。构建了弗莱德衰弱表型的改良版。药物负担指标为多药治疗、药物负担指数（DBI）、抗胆碱能认知负担（ACB）和镇静剂负荷模型。使用多项逻辑回归计算比值比（OR）并确定衰弱与药物负担之间的关联。
本研究纳入了 570 名 ID 参与者。过度多药治疗（使用≥10 种药物）与虚弱前期（P = 0.017；OR = 2.56；95%置信区间 [CI] 1.19-5.50）和虚弱（P < 0.001；OR 7.13；95% CI 2.81-18.12）显著相关，但 DBI、ACB 或镇静剂负荷评分与衰弱状态无关（P > 0.05）。
这是第一项研究智力障碍老年人衰弱及其与药物使用（包括抗胆碱能药物和镇静药物负担）之间关系的研究。需要进一步研究其他衰弱模型测量的衰弱与 ID 老年人药物负担之间的关系。
