title: Central nervous system medication use in older adults with intellectual disability: Results from the successful ageing in intellectual disability study.
abstract: OBJECTIVE
  Information on the rates and predictors of polypharmacy of central nervous system medication in older people with intellectual disability is limited, despite the increased life expectancy of this group. This study examined central nervous system medication use in an older sample of people with intellectual disability.
  
  
  METHODS
  Data regarding demographics, psychiatric diagnoses and current medications were collected as part of a larger survey completed by carers of people with intellectual disability over the age of 40 years. Recruitment occurred predominantly via disability services across different urban and rural locations in New South Wales and Victoria. Medications were coded according to the Monthly Index of Medical Specialties central nervous system medication categories, including sedatives/hypnotics, anti-anxiety agents, antipsychotics, antidepressants, central nervous system stimulants, movement disorder medications and anticonvulsants. The Developmental Behaviour Checklist for Adults was used to assess behaviour.
  
  
  RESULTS
  Data were available for 114 people with intellectual disability. In all, 62.3% of the sample was prescribed a central nervous system medication, with 47.4% taking more than one. Of those who were medicated, 46.5% had a neurological diagnosis (a seizure disorder or Parkinson's disease) and 45.1% had a psychiatric diagnosis (an affective or psychotic disorder). Linear regression revealed that polypharmacy was predicted by the presence of neurological and psychiatric diagnosis, higher Developmental Behaviour Checklist for Adults scores and male gender.
  
  
  CONCLUSIONS
  This study is the first to focus on central nervous system medication in an older sample with intellectual disability. The findings are in line with the wider literature in younger people, showing a high degree of prescription and polypharmacy. Within the sample, there seems to be adequate rationale for central nervous system medication prescription. Although these data do not indicate non-adherence to guidelines for prescribing in intellectual disability, the high rate of polypharmacy and its relationship to Developmental Behaviour Checklist for Adults scores reiterate the importance of continued medication review in older people with intellectual disability.
authors.affiliation: Department of Developmental Disability Neuropsychiatry, UNSW Australia, Sydney, NSW, Australia.
authors.forename: Kate M
authors.initials: KM
authors.lastname: Chitty
authors.affiliation: Department of Developmental Disability Neuropsychiatry, UNSW Australia, Sydney, NSW, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Evans
authors.affiliation: Centre for Developmental Disability Health, Monash University, Notting Hill, VIC, Australia.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Torr
authors.affiliation: La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia.
authors.forename: Teresa
authors.initials: T
authors.lastname: Iacono
authors.affiliation: Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia Dementia Collaborative Research Centre, UNSW Australia, Sydney, NSW, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia.
authors.forename: Perminder
authors.initials: P
authors.lastname: Sachdev
authors.affiliation: Department of Developmental Disability Neuropsychiatry, UNSW Australia, Sydney, NSW, Australia Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia j.trollor@unsw.edu.au.
authors.forename: Julian N
authors.initials: JN
authors.lastname: Trollor
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000150:complications / Q000188:drug therapy; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000188:drug therapy; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy; D019338:Polypharmacy; D012640:Seizures / Q000150:complications / Q000188:drug therapy
chemical_list: D014151:Anti-Anxiety Agents; D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: Intellectual disability; central nervous system medication; challenging behaviour; polypharmacy