Association of Drug Burden Index with grip strength, timed up and go and Barthel index activities of daily living in older adults with intellectual disabilities: an observational cross-sectional study

Abstract

Background Drug Burden Index (DBI), a measure of exposure to medications with anticholinergic and sedative activity, has been associated with poorer physical function in older adults in the general population. While extensive study has been conducted on associations between DBI and physical function in older adults in the general population, little is known about associations in older adults with intellectual disabilities (ID). This is the first study which aims to examine the association between DBI score and its two sub-scores, anticholinergic and sedative burden, with two objective measures of physical performance, grip strength and timed up and go, and a measure of dependency, Barthel Index activities of daily living, in older adults with ID. Methods Data from Wave 2 (2013/2014) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) was analysed. Analysis of Covariance (ANCOVA) was used to detect associations and produce adjusted means for the physical function and dependency measures with respect to categorical DBI scores and the anticholinergic and sedative sub-scores (DBA and DBS). Results After adjusting for confounders (age, level of ID, history of falls, comorbidities and number of non-DBI medications, Down syndrome (grip strength only) and gender (timed up and go and Barthel Index)), neither grip strength nor timed up and go were significantly associated with DBI, DBA or DBS score > 0 ( p > 0.05). Higher dependency in Barthel Index was associated with DBS exposure ( p < 0.001). Conclusions DBI, DBA or DBS scores were not significantly associated with grip strength or timed up and go. This could be as a result of established limitations in physical function in this cohort, long-term exposure to these types of medications or lifelong sedentary lifestyles. Higher dependency in Barthel Index activities of daily living was associated with sedative drug burden, which is an area which can be examined further for review. Electronic supplementary material The online version of this article (10.1186/s12877-019-1190-3) contains supplementary material, which is available to authorized users.

Medication burden and frailty in older adults with intellectual disability: An observational cross‐sectional study

“…This study used data from Wave 2 (2013/2014) of the ID Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA), a nationally representative study of older adults with ID in Ireland. This study has been described in detail elsewhere . Ethical approval for the study was granted by the Faculty of Health Sciences Research Ethics Committee in Trinity College Dublin and local and/or regional ethical committee approval was granted from each service provider (n = 138).…”

“…Drug Burden Index : Drug Burden Index (DBI) was used to capture dose‐related exposure of an individual to regular anticholinergic and sedative medications. Full details of this measure are available in previous publications …”

“…In spite of the known associations between polypharmacy, anticholinergic and sedative exposure with frailty in older adults without ID, and the high levels of exposure to these amongst people with ID, little research has been performed to assess the association between frailty by any measure with medication exposure in older adults with ID.…”

Effects of medical insurance system and nursing care on the hospitalization cost effectiveness of acute myocardial infarction patients

“…Although there are differences in age among different health insurance status, after controlling for age, the hospital still spends the most at free medical care. Comorbidity due to age [7] , increased reliance on nursing [8] , the prolonged length of stay [9] , may cause medication cost [7] , the cost of the nurse, and longer duration of hospitalization. But after controlling for age, a greater difference between different health insurance status costs for medicine, nursing, and length of stay is still signi cant.…”

Effects of Medical Insurance System and Nursing Care on the Hospitalization Cost Effectiveness of Acute Myocardial Infarction Patients

“…Although there are differences in age among different health insurance status, after controlling for age, the hospital still spends the most at free medical care. Comorbidity due to age [7] , increased reliance on nursing [8] , the prolonged length of stay [9] , may cause medication cost [7] , the cost of the nurse, and longer duration of hospitalization. But after controlling for age, a greater difference between different health insurance status costs for medicine, nursing, and length of stay is still signi cant.…”