Ten-Year Outcomes of Anticholinergic Use Among Older Adults With Intellectual Disability: Findings From the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA).

This was an observational cohort, so it can show associations but cannot prove that anticholinergic burden caused falls or mental health problems. The dementia finding involved very few reported cases and wide confidence intervals, so the lower odds should not be read as a protective effect. Dementia diagnosis in intellectual disability is difficult and may be underreported, especially in people with Down syndrome. Only Wave 1 and Wave 4 were analysed, so medication changes during the intervening waves were not examined. Some outcomes that could matter clinically, such as frailty, cognitive impairment and daytime dozing, were not measured.

The authors declared no conflicts of interest. The work was funded by the Health Research Board and the Department of Health in Dublin, Ireland, and by Trinity College Dublin.

Do not read the lower dementia odds as evidence that anticholinergics protect against dementia. The study had very few dementia cases and wide uncertainty, and it cannot prove causation.