125Use of the Sedative Load Model in Older Adults with Intellectual Disabilities

Abstract

Background: The Sedative Load (SL) model is a quantitative measure of exposure to regular sedative medications. Exposure to these types of medications has been associated with poorer physical function in older adults. Objective: To describe SL in a cohort of older adults with intellectual disabilities (ID) and evaluate its relationship with demographics and clinical characteristics. Methods: Data from Wave 2 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA), a representative observational cross-sectional study on ageing of people with ID in Ireland, were analysed. Quantitative data analysis was used. Chi square analysis was used to assess associations between SL scores and categorical variables (gender, age, type of residence, level of ID, history of falls, epilepsy). Analysis of Variance was used to assess associations with continuous variables (comorbidities, measured by Functional Comorbidity Index, and Barthel Index activities of daily living). Results: 677 (95.6%) participants had medication data available for analysis. 73.3% (n = 496) of participants were exposed to a regular sedative medication. Mean SL score was 2.7 (SD 2.5). SL score was significantly associated with gender, level of ID, type of residence, behaviours that challenge, epilepsy diagnosis, having a mental health condition, number of comorbidities and Barthel Index (p < 0.001). SL score was not associated with age range (p = 0.356) or history of falls (p = 0.136). Conclusion: Overall sedative exposure and SL scores for this group were much higher than for studies of the general older population. While associations with demographics are similar to that seen in older adults without ID, history of falls was not associated with SL score. This could reflect the greater monitoring and lower physical activity levels in this population. The potential impact of high sedative load on quality of life requires further investigation and could provide knowledge for effective medication therapy review.