title: Factors associated with polypharmacy and excessive polypharmacy in older people with intellectual disability differ from the general population: a cross-sectional observational nationwide study.
abstract: OBJECTIVE
  (1) To evaluate the prevalence of polypharmacy (5-9 medicines) and excessive polypharmacy (10+ medicines) and (2) to determine associated demographic and clinical characteristics in an ageing population with intellectual disabilities (IDs).
  
  
  METHODS
  Observational cross-sectional study.
  
  
  METHODS
  Wave One (2009/2010) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA).
  
  
  METHODS
  A nationally representative sample of 753 persons with ID, aged between 41 and 90 years. Participants/proxy reported medicines (prescription and over the counter) taken on a regular basis; medication data was available for 736 participants (98%).
  Participants were divided into those with no polypharmacy (0-4 medicines), polypharmacy (5-9 medicines) and excessive polypharmacy (10+ medicines). Medication use patterns were analysed according to demographic variables and reported chronic conditions. A multinomial logistic regression model identified factors associated with polypharmacy (5-9 medicines) and excessive polypharmacy (≥10 medicines).
  
  
  RESULTS
  Overall, 90% of participants reported use of medicines. Polypharmacy was observed in 31.5% of participants and excessive polypharmacy in 20.1%. Living in a residential institution, and reporting a mental health or neurological condition were strongly associated with polypharmacy and excessive polypharmacy after adjusting for confounders, but age or gender had no significant effect.
  
  
  CONCLUSIONS
  Polypharmacy was commonplace for older adults with ID and may be partly explained by the high prevalence of multimorbidity reported. Review of appropriateness of medication use is essential, as polypharmacy places ageing people with ID at risk of adverse effects.
authors.affiliation: School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland IDS-TILDA School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
authors.forename: Máire
authors.initials: M
authors.lastname: O'Dwyer
authors.affiliation: School of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Jure
authors.initials: J
authors.lastname: Peklar
authors.affiliation: Center for Excellence in Aging and Community Wellness, University At Albany, New York, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: McCallion
authors.affiliation: Dean of the Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: McCarron
authors.affiliation: School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
authors.forename: Martin C
authors.initials: MC
authors.lastname: Henman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002908:Chronic Disease / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008607:Intellectual Disability; D007494:Ireland; D054368:Laxatives / Q000627:therapeutic use; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D019338:Polypharmacy; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D054368:Laxatives
keywords: intellectual disability; multimorbidity; polypharmacy