Prescribing requirements of the elderly mentally handicapped: future demands on primary health care teams.

The medication prescribed for 269 mentally handicapped hospital residents aged 60 years and over on 1 January 1987, including five with Down's syndrome, and for 31 residents aged 50 years or over with Down's syndrome was analysed.Fifty of the 269 elderly residents were receiving no medication but the mean number of prescriptions for the remaining 219 was four. Of the total sample of 269 residents, 32% were taking drugs for psychiatric and psychological disorders; 11% regular antiepileptic drugs; 62% long-term drugs for other problems (diuretics and laxatives were the most common); 29% had long-term prescriptions for topical preparations, enemata or suppositories; 23% were on shortterm prescriptions for other problems; and 17% had short-term prescriptions for topical preparations, enemata or suppositories. For the 31 Down's syndrome residents the commonest prescriptions were for skin preparations.Particular care is needed in making a diagnosis and monitoring the effects of treatment on mentally handicapped patients because a complete history and full cooperation on examination may not be forthcoming. These findings have implications for primary health care teams who will be responsible for the mentally handicapped when hospitals close and the residents live in the community.