1
|
Rutherford G, Hussain R, Tait K. Pattern of multimorbidity in middle-aged and older-aged people with mild intellectual disability in Australia. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13215. [PMID: 38413378 DOI: 10.1111/jar.13215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/15/2023] [Accepted: 12/12/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Non-communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill-health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid-aged and older-aged people with mild intellectual disability. METHOD Comparative data comes from two cross-sectional surveys using similar methodology and timeframes. The analysis sample comprises mid-aged group (30-50 years, N = 291) and older-aged group (≥60 years, N = 391). RESULTS People with mild intellectual disability start developing NCDs in early to mid-adulthood and increases with age. The mean number of NCDs in mid-aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). CONCLUSION There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement.
Collapse
Affiliation(s)
- Grace Rutherford
- School of Medicine & Psychology, Australian National University, Canberra, Australia
| | - Rafat Hussain
- School of Medicine & Psychology, Australian National University, Canberra, Australia
| | - Kathleen Tait
- Macquarie School of Education, Macquarie University, Sydney, Australia
| |
Collapse
|
2
|
Zandam H, Akobirshoev I, Mitra M. Multiple Chronic Condition Emergency Department Visits Among U.S. Adults: Disparities at the Intersection of Intellectual and Developmental Disabilities Status and Race or Ethnicity. Health Equity 2024; 8:198-205. [PMID: 38559846 PMCID: PMC10979663 DOI: 10.1089/heq.2023.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 04/04/2024] Open
Abstract
Background The study aims to examine the risk of multiple chronic condition (MCC)-related emergency department (ED) visits, MCC-related hospitalization following the ED visit, and mortality after MCC-related ED visits among adults with intellectual and developmental disabilities (IDD), adults compared with nondisabled adults by race and ethnicity, using the 2020 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample. Methods We identified IDD adults using ICD-10-CM codes, extracting 296,394 nondisabled adults and 99,538 IDD adults, of which 67,771 are white, 19,164 are black, 10,667 are Latinx, and 1936 are other race or multiple race. The control group of nondisabled adults was age-matched and sex-matched in a 1:3 case-control ratio. We conducted multilevel Poisson regression models for the binary-dependent variables and adjusted for covariates, including sociodemographic and hospital characteristics. Results The results show that across all racial/ethnic groups, individuals with IDD have significantly higher rates of MCC-related ED visits, hospitalizations, and deaths compared with nondisabled. Moreover, the disparities are more pronounced for individuals from racial/ethnic minority groups. Black and Latinx individuals with IDD have significantly higher rates of MCC-related ED visits and poor outcomes than their white counterparts with and without IDD. Conclusions The findings from this study highlight significant racial and ethnic disparities in the risk of MCC-related ED visits, hospitalization following the ED visit, and mortality through the ED among IDD adults. This underscores the importance of adopting a multifaceted approach that addresses the social determinants of health, enhances access to health care, improves quality of care, and enhances care coordination.
Collapse
Affiliation(s)
- Hussaini Zandam
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Ilhom Akobirshoev
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Monika Mitra
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| |
Collapse
|
3
|
Mann C, Jun GT. A scoping review of clusters of multiple long-term conditions in people with intellectual disabilities and factors impacting on outcomes for this patient group. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:1045-1061. [PMID: 35695384 PMCID: PMC10647926 DOI: 10.1177/17446295221107275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
People with intellectual disabilities (ID) are vulnerable to multiple long-term conditions (MLTC). However, in the UK, there are no individual strategies tailored for them. This study synthesised evidence on prevalence of MLTC in people with ID alongside risk factors, outcomes and preventative strategies. The scoping review used the tool Abstrackr to search retrieved articles from three bibliographic databases. Of 933 articles initially screened and further identified, 20 papers met our inclusion criteria. Our findings revealed significant data on prevalence of MLTC in people with ID across the studies, but very limited data on clusters or patterns of co-occurrence in this population. The majority of papers explored risk factors and strategies for prevention of MLTC, but far fewer compared outcomes by MLTC. The identified gaps in the literature indicate the need for further research to identify clusters of MLTC and tailored prevention strategies to reduce poor outcomes in this population.
Collapse
Affiliation(s)
- Claire Mann
- School of Design and Creative Arts, Loughborough University, Loughborough, UK
| | - Gyuchan T Jun
- School of Design and Creative Arts, Loughborough University, Loughborough, UK
| |
Collapse
|
4
|
van den Bemd M, Cuypers M, Schalk BW, Leusink GL, Bischoff EW. Chronic disease management in patients with intellectual disabilities: a matched study in Dutch general practice. Br J Gen Pract 2023; 73:e744-e751. [PMID: 37666513 PMCID: PMC10498381 DOI: 10.3399/bjgp.2023.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/12/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Disease management programmes (DMPs) aim to deliver standardised, high- quality care to patients with chronic diseases. Although chronic diseases are common among people with intellectual disabilities (ID), this approach may be suboptimal for meeting their care needs. AIM To examine differences between patients with and without ID who have a chronic illness in DMP enrolment and disease monitoring in Dutch general practice. DESIGN AND SETTING Observational study utilising the Nivel Primary Care Database (2015-2018) comparing patients with ID and cardiovascular disease, diabetes mellitus, or chronic obstructive pulmonary disease (COPD) with matched (1:5) controls with these conditions but without ID. METHOD Using conditional logistic regression, enrolment in DMP per chronic disease was examined and differences tested between groups in the frequencies of consultations, medication prescriptions, and routine examinations. RESULTS A total of 2653 patients with chronic illness with ID were matched with 13 265 controls without ID. Patients with both diabetes mellitus and ID were more likely than controls to be enrolled in DMP (odds ratio [OR] = 1.44, 95% confidence interval [CI] = 1.27 to 1.64). Independent of DMP enrolment, patients with chronic illness with ID were more likely than controls to have frequent consultations. Patients with both diabetes mellitus and ID and patients with both COPD and ID who were not enrolled in DMPs had more medication prescriptions than non-enrolled patients with diabetes or COPD but without ID (OR = 1.46, 95% CI = 1.10 to 1.95; OR = 1.28, 95% CI = 0.99 to 1.66, respectively). Most patients with ID and their controls enrolled in DMPs received routine examinations at similar frequencies. CONCLUSION Although DMPs do not specifically address the needs of patients with both chronic illness and ID, these patients do not seem underserved in the management of chronic diseases in terms of consultation, medication, and tests.
Collapse
Affiliation(s)
- Milou van den Bemd
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Maarten Cuypers
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Bianca Wm Schalk
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Geraline L Leusink
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Erik Wma Bischoff
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands
| |
Collapse
|
5
|
Wark S, Hussain R, Janicki MP, Knox M, Parmenter T. Perceived health and wellbeing among community-dwelling older Australians with intellectual disability: A comparison with age peers. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:777-793. [PMID: 35522188 DOI: 10.1177/17446295221100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Data specifically comparing outcomes for people with and without intellectual disability is limited. This paper reports perceived health and wellbeing of older Australians resident in metropolitan and rural locations in New South Wales and Queensland. Respondents were community-residing individuals with intellectual disability and mainstream age peers [age ≥ 60]. Measures included SF12; Cummings well-being scales; DSSI; Adverse Life Events; and financial hardship status. The sample was composed of 391 adults with intellectual disability and 920 age peers. Adults with intellectual disability were significantly more likely to note adverse life events, worse mental health, and lower levels of social support, but reported higher mean wellbeing scores and had higher scores for physical health. Results indicated higher likelihood of adults with intellectual disability reporting comparative disadvantage across multiple key areas when compared to age peers.
Collapse
Affiliation(s)
- Stuart Wark
- University of New England, Armidale, NSW, Australia
| | - Rafat Hussain
- Australian National University, Canberra, ACT, Australia
| | | | | | | |
Collapse
|
6
|
Wiese MY, Stancliffe RJ, Durvasula S, Piepers DW, Wilson NJ. Analysis of an Australian death database of people with intellectual disability living out of the family home: Place of death and associated variables. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023:17446295231175541. [PMID: 37192146 DOI: 10.1177/17446295231175541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This study reports on a five-year data set about the deaths of 599 individuals in New South Wales Australia, who at the time of their death were living in out-of-home care. Analysis aimed to: i) gain a clearer understanding of place of death for people with intellectual disability; and ii) identify and analyse associated variables to investigate how well they predict place of death for this population. Hospital admissions, polypharmacy and living situation were the strongest standalone predictors of place of death. A hospital death was more likely if the target population were subject to polypharmacy, lived in a group home, had a moderate intellectual disability or had GORD. Death, and place of death, is an issue requiring individual consideration. This study has identified some of the variables that need attention when supporting people with intellectual disability to have a good death.
Collapse
Affiliation(s)
| | - Roger J Stancliffe
- Sydney School of Health Sciences, Centre for Disability Research and Policy, The University of Sydney, Australia
| | - Seeta Durvasula
- Sydney Medical School, Centre for Disability Studies, The University of Sydney, Australia
| | | | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Australia
| |
Collapse
|
7
|
van den Bemd M, Schalk BWM, Bischoff EWMA, Cuypers M, Leusink GL. Chronic diseases and comorbidities in adults with and without intellectual disabilities: comparative cross-sectional study in Dutch general practice. Fam Pract 2022; 39:1056-1062. [PMID: 35579254 PMCID: PMC9680667 DOI: 10.1093/fampra/cmac042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Chronic disease and comorbidity patterns in people with intellectual disabilities (ID) are more complex than in the general population. However, incomplete understanding of these differences limits care providers in addressing them. OBJECTIVE To compare chronic disease and comorbidity patterns in chronically ill patients with and without ID in Dutch general practice. METHODS In this population-based study, a multi-regional primary care database of 2018 was combined with national population data to improve identification of adults with ID. Prevalence was calculated using Poisson regression to estimate prevalence ratios and 95% confidence intervals for the highest-impact chronic diseases (ischemic heart disease (IHD), cerebrovascular disease (CVD), diabetes mellitus (DM), and chronic obstructive pulmonary disease (COPD)) and comorbidities. RESULTS Information from 18,114 people with ID and 1,093,995 people without ID was available. When considering age and sex, CVD (PR = 1.1), DM (PR = 1.6), and COPD (PR = 1.5) times more prevalent in people with than without ID. At younger age, people with ID more often had a chronic disease and multiple comorbidities. Males with ID most often had a chronic disease and multiple comorbidities. Comorbidities of circulatory nature were most common. CONCLUSIONS This study identified a younger onset of chronic illness and a higher prevalence of multiple comorbidities among people with ID in general practice than those without ID. This underlines the complexity of people with ID and chronic diseases in general practice. As this study confirmed the earlier onset of chronic diseases and comorbidities, it is recommended to acknowledge these age differences when following chronic disease guidelines.
Collapse
Affiliation(s)
- Milou van den Bemd
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bianca W M Schalk
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erik W M A Bischoff
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maarten Cuypers
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geraline L Leusink
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
8
|
Miot S, Chancel R, Peries M, Crepiat S, Couderc S, Pernon E, Picot MC, Gonnier V, Jeandel C, Blain H, Baghdadli A. Multimorbidity patterns and subgroups among autistic adults with intellectual disability: Results from the EFAAR study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:762-777. [PMID: 36056616 DOI: 10.1177/13623613221121623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Multimorbidity relates to having multiple chronic health conditions. It is a risk factor for poor health and reduces life expectancy. Autistic people have multiple chronic health conditions and die prematurely, especially if they have an intellectual disability (autism spectrum disorder and intellectual disability). Certain pathophysiological processes observed in autism spectrum disorder are common to those related to the genesis and/or maintenance of multimorbidity. Furthermore, multimorbidity could be helpful in better identifying patient subgroups in autism spectrum disorder. It is therefore essential to better characterize multimorbidity and its consequences in the subgroup of autism spectrum disorder + intellectual disability individuals to offer them personalized care. We conducted a preliminary study of 63 autism spectrum disorder + intellectual disability adults to classify them according to their multimorbidity and search for a specific combination of chronic health conditions. We observed high and early multimorbidity in this sample and identified four classes of participants, distinguished by their multimorbidity status, independence and number of treatments. In addition, we observed a dominant combination of multimorbidity in our sample, combining immune dysfunction and gastrointestinal disorders, neurological and joint diseases. These findings support the hypothesis that an altered gut-brain relationship is involved in the risk of autism spectrum disorder, its outcome, and its association with chronic health conditions. Although larger studies are needed, our results suggest that subgroups of autism spectrum disorder + intellectual disability individuals can be identified based on their multimorbidity and potentially different ageing trajectories. A more comprehensive and personalized approach is needed to reduce the burden of multimorbidity and increase the quality of life and life expectancy in autism spectrum disorder/ intellectual disability.
Collapse
Affiliation(s)
- Stéphanie Miot
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France.,CESP, INSERM U1178, Centre de recherche en Epidemiologie et Santé des Populations, Villejuif, France
| | - Raphaël Chancel
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France.,Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France
| | - Marianne Peries
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France.,Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France
| | - Sophie Crepiat
- Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France
| | - Sylvie Couderc
- Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France
| | - Eric Pernon
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France.,Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France
| | - Marie-Christine Picot
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France.,CESP, INSERM U1178, Centre de recherche en Epidemiologie et Santé des Populations, Villejuif, France
| | - Véronique Gonnier
- Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France
| | - Claude Jeandel
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France
| | - Hubert Blain
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France
| | - Amaria Baghdadli
- Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France.,CESP, INSERM U1178, Centre de recherche en Epidemiologie et Santé des Populations, Villejuif, France.,Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France
| |
Collapse
|
9
|
Simón-Siles S, Font-Farré M, Guerra-Balic M, Nishishinya-Aquino MB, Oviedo GR. Effects of exercise on fitness in adults with intellectual disability: a protocol of an overview of systematic reviews. BMJ Open 2022; 12:e058053. [PMID: 35379636 PMCID: PMC8981361 DOI: 10.1136/bmjopen-2021-058053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Adults with intellectual disability (ID) have lower physical fitness levels than their peers without disabilities, representing a risk to their health since physical activity and cardiorespiratory fitness are directly related to better health and quality of life. Therefore, it is essential to determine the effects that exercise can have on them, as adults with ID present high comorbidities and lower life expectancy, altogether with lower rates of physical activity. The current overview of systematic reviews aims to provide an outline of the exercise benefits in health-related and skill-related fitness in adults with ID. METHODS AND ANALYSIS Research will be conducted in PubMed, CENTRAL, EMBASE, PEDro, SPORTDiscus and CINAHL. The search terms will be categorised through population (eg, adult, ID); intervention (eg, exercise, physical activity) and outcomes (eg, cardiorespiratory fitness, body composition, muscular strength, muscular endurance, flexibility, balance, power, speed, agility, coordination, mobility and reaction time). Each database will be searched from their earliest available record up to 30 September 2021.Inclusion criteria will be: systematic reviews including at least one RCT that compare exercise interventions with a control group or another type of intervention; measure of fitness using objectives methods; inclusion of adults with ID (≥18 years old), and published in any language, with at least their abstract in English, Spanish, French and/or Portuguese. ETHICS AND DISSEMINATION To our knowledge, our overview will be the first of its kind to address the topic in people with ID. The results could be used to determine which fitness components can be improved by exercise and to provide a valuable tool to develop comprehensive exercise programmes specific to people with ID. Ethical approval is not required. The knowledge generated will be disseminated electronically and in print and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42021237580.
Collapse
Affiliation(s)
- Sandra Simón-Siles
- Blanquerna Ramon Llull University Faculty of Psychology Education and Sport Sciences, Barcelona, Catalunya, Spain
| | - Manel Font-Farré
- Blanquerna Ramon Llull University Faculty of Psychology Education and Sport Sciences, Barcelona, Catalunya, Spain
| | - Myriam Guerra-Balic
- Blanquerna Ramon Llull University Faculty of Psychology Education and Sport Sciences, Barcelona, Catalunya, Spain
| | | | - Guillermo R Oviedo
- Blanquerna Ramon Llull University Faculty of Psychology Education and Sport Sciences, Barcelona, Catalunya, Spain
| |
Collapse
|
10
|
Vancampfort D, Schuch F, Van Damme T, Firth J, Suetani S, Stubbs B, Van Biesen D. Prevalence of diabetes in people with intellectual disabilities and age- and gender-matched controls: A meta-analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:301-311. [PMID: 34658096 DOI: 10.1111/jar.12949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/15/2021] [Accepted: 09/23/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND This meta-analysis aims to: (i) describe the pooled prevalence of diabetes in people with intellectual disabilities, (ii) investigate the association with demographic, clinical and treatment-related factors and (iii) compare the prevalence versus age- and gender-matched general population controls. METHODS Pubmed, Embase and CINAHL were searched until 01 May 2021. Random effects meta-analysis and an odds ratio analysis were conducted to compare rates with controls. RESULTS The trim- and fill-adjusted pooled diabetes prevalence amongst 55,548 individuals with intellectual disabilities (N studies = 33) was 8.5% (95% CI = 7.2%-10.0%). The trim- and fill-adjusted odds for diabetes was 2.46 times higher (95% CI = 1.89-3.21) (n = 42,684) versus controls (n = 4,177,550). Older age (R2 = .83, p < .001), smoking (R2 = .30, p = .009) and co-morbid depression (R2 = .18, p = .04), anxiety (R2 = .97, p < .001), and hypertension (R2 = 0.29, p < .001) were associated with higher diabetes prevalence rates. CONCLUSIONS Our findings demonstrate that people with intellectual disabilities are at an increased risk of diabetes, and therefore routine screening and multidisciplinary management of diabetes is needed.
Collapse
Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
- School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | | |
Collapse
|
11
|
Kudesia P, Salimarouny B, Stanley M, Fortin M, Stewart M, Terry A, Ryan BL. The incidence of multimorbidity and patterns in accumulation of chronic conditions: A systematic review. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2021; 11:26335565211032880. [PMID: 34350127 PMCID: PMC8287424 DOI: 10.1177/26335565211032880] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/24/2021] [Indexed: 12/17/2022]
Abstract
Multimorbidity, the presence of 1+ chronic condition in an individual, remains one of the greatest challenges to health on a global scale. Although the prevalence of multimorbidity has been well-established, its incidence is not fully understood. This systematic review determined the incidence of multimorbidity across the lifespan; the order in which chronic conditions accumulate to result in multimorbidity; and cataloged methods used to determine and report accumulation of chronic conditions resulting in multimorbidity. Studies were identified by searching MEDLINE, Embase, CINAHL, and Cochrane electronic databases. Two independent reviewers evaluated studies for inclusion and performed quality assessments. Of 36 included studies, there was high heterogeneity in study design and operational definitions of multimorbidity. Studies reporting incidence (n = 32) reported a median incidence rate of 30.7 per 1,000 person-years (IQR 39.5 per 1,000 person-years) and a median cumulative incidence of 2.8% (IQR 28.7%). Incidence was notably higher for persons with older age and 1+ chronic conditions at baseline. Studies reporting patterns in accumulation of chronic conditions (n = 5) reported hypertensive and heart diseases, and diabetes, as among the common starting conditions resulting in later multimorbidity. Methods used to discern patterns were highly heterogenous, ranging from the use of latent growth trajectories to divisive cluster analyses, and presentation using alluvial plots to cluster trajectories. Studies reporting the incidence of multimorbidity and patterns in accumulation of chronic conditions vary greatly in study designs and definitions used. To allow for more accurate estimations and comparison, studies must be transparent and consistent in operational definitions of multimorbidity applied.
Collapse
Affiliation(s)
- Prtha Kudesia
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Banafsheh Salimarouny
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
| | - Meagan Stanley
- Allyn & Betty Taylor Library, University of Western
Ontario, London, Ontario, Canada
| | - Martin Fortin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Moira Stewart
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Amanda Terry
- Schulich Interfaculty Program in Public Health, University of Western
Ontario, London, Ontario, Canada
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| | - Bridget L Ryan
- Centre for Studies in Family Medicine & Department of Family
Medicine, Schulich School of Medicine & Dentistry, University of Western
Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of
Medicine & Dentistry, University of Western Ontario, London, Ontario,
Canada
| |
Collapse
|