165Association of Drug Burden Index with Physical Function in Irish Older Adults with Intellectual Disability

Abstract

Background: The Drug Burden Index (DBI) is a tool which quantitatively evaluates the burden from anticholinergic and sedative medications [1]. DBI scores have been associated with poorer physical performance in older adults without intellectual disability (ID). This study aims to evaluate the association between DBI scores and two physical function measures-Barthel Index (BI) activities of daily living (lower scores indicate greater dependence) and Functional Comorbidity Index (FCI) in older adults with ID. Methods: Data from Wave 2 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) were analysed. Analysis of Covariance (ANCOVA) was used to compare adjusted means of two physical function measures - BI and FCI. Means were adjusted for gender, age, level of ID, and history of falls. Means for BI were also adjusted for comorbidities. Results: Of the 677 with medication data, 24.4% (n = 165) had a DBI score 0-1, 54.2% (n = 367) had a DBI score of 1+. After adjusting for confounders, DBI 1+ was associated with higher dependence in BI activities of daily living (p = 0.002). Both DBI 0-1 and DBI 1+ were associated with higher FCI scores (p = 0.018 and p < 0.001, respectively). Conclusions: Higher Drug Burden Index was significantly associated with poorer physical function and less independence in older adults with ID. This tool could be useful to trigger medication review and optimising use of anticholinergic and sedative medications in older adults with ID, potentially improving quality of life.