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Öztürk ME, Yabanci Ayhan N. The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:325-339. [PMID: 38183317 DOI: 10.1111/jir.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. METHODS The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5 ± 7 years (range 18-60 years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5 kg/m2 ), normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ) and obese (≥30 kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. RESULTS Participants had mild (42.3%; n = 30), moderate (29.6%; n = 21) or severe IDD (28.2%; n = 20). They were underweight (12.7%; n = 9), normal weight (59.2%; n = 42) or overweight and/or obese (28.2%; n = 20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. CONCLUSIONS While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.
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Affiliation(s)
- M E Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - N Yabanci Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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Mahar AL, Biggs K, Hansford RL, Derksen S, Griffiths R, Enns JE, Dawe DE, Hallet J, Kristjanson M, Decker K, Cobigo V, Shooshtari S, Stirling M, Kelly C, Brownell M, Turner D, Ouellette-Kuntz H. Stage IV breast, colorectal, and lung cancer at diagnosis in adults living with intellectual or developmental disabilities: A population-based cross-sectional study. Cancer 2024; 130:740-749. [PMID: 37902956 DOI: 10.1002/cncr.35068] [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: 04/04/2023] [Revised: 08/23/2023] [Accepted: 09/13/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Cancer is a leading cause of death among people living with intellectual or developmental disabilities (IDD). Although studies have documented lower cancer screening rates, there is limited epidemiological evidence quantifying potential diagnostic delays. This study explores the risk of metastatic cancer stage for people with IDD compared to those without IDD among breast (female), colorectal, and lung cancer patients in Canada. METHODS Separate population-based cross-sectional studies were conducted in Ontario and Manitoba by linking routinely collected data. Breast (female), colorectal, and lung cancer patients were included (Manitoba: 2004-2017; Ontario: 2007-2019). IDD status was identified using established administrative algorithms. Modified Poisson regression with robust error variance models estimated associations between IDD status and the likelihood of being diagnosed with metastatic cancer. Adjusted relative risks were pooled between provinces using random-effects meta-analyses. Potential effect modification was considered. RESULTS The final cohorts included 115,456, 89,815, and 101,811 breast (female), colorectal, and lung cancer patients, respectively. Breast (female) and colorectal cancer patients with IDD were 1.60 and 1.44 times more likely to have metastatic cancer (stage IV) at diagnosis compared to those without IDD (relative risk [RR], 1.60; 95% confidence interval [CI], 1.16-2.20; RR, 1.44; 95% CI, 1.24-1.67). This increased risk was not observed in lung cancer. Significant effect modification was not observed. CONCLUSIONS People with IDD were more likely to have stage IV breast and colorectal cancer identified at diagnosis compared to those without IDD. Identifying factors and processes contributing to stage disparities such as lower screening rates and developing strategies to address diagnostic delays is critical.
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Affiliation(s)
- Alyson L Mahar
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
- School of Nursing, Queen's University, Kingston, Ontario, Canada
- ICES, Ontario, Toronto, Canada
| | - Kelly Biggs
- ICES, Ontario, Toronto, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Rebecca L Hansford
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Shelley Derksen
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Jennifer E Enns
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David E Dawe
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- CancerCare Manitoba Research Institute, Winnipeg, Manitoba, Canada
| | - Julie Hallet
- ICES, Ontario, Toronto, Canada
- Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark Kristjanson
- CancerCare Manitoba Research Institute, Winnipeg, Manitoba, Canada
- St. Amant Research Centre, Winnipeg, Manitoba, Canada
- Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kathleen Decker
- CancerCare Manitoba Research Institute, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Virginie Cobigo
- ICES, Ontario, Toronto, Canada
- Department of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Shahin Shooshtari
- St. Amant Research Centre, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Morgan Stirling
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christine Kelly
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marni Brownell
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Donna Turner
- CancerCare Manitoba Research Institute, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Hélène Ouellette-Kuntz
- ICES, Ontario, Toronto, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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Lin E, Lunsky Y, Chung H, Durbin A, Volpe T, Dobranowski K, Benadict MB, Balogh R. Amenable deaths among adults with intellectual and developmental disabilities including Down syndrome: An
Ontario
population‐based cohort study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 36:165-175. [DOI: 10.1111/jar.13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Elizabeth Lin
- Office of Education, Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
| | - Yona Lunsky
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health Toronto Ontario Canada
| | | | - Anna Durbin
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- ICES Toronto Ontario Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital Toronto Ontario Canada
| | - Tiziana Volpe
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health Toronto Ontario Canada
| | | | | | - Robert Balogh
- ICES Toronto Ontario Canada
- Faculty of Health Sciences, Ontario Tech University Oshawa Ontario Canada
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Ratnayake I, Shooshtari S, Chateau D, Kristjanson M. Complete physical examinations in Manitoba adults with an intellectual or developmental disability: A retrospective cohort study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1582-1591. [PMID: 34196454 DOI: 10.1111/jar.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 04/26/2021] [Accepted: 05/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Complete physical examinations (CPE) can identify health disparities in persons with intellectual or developmental disabilities. The objective of this study was to determine and compare rates of CPE among Manitoba adults with and without intellectual or developmental disabilities over time and to identify factors that were associated with receiving a CPE. METHOD A retrospective cohort study using linked administrative health and non-health data from 1995 to 2015 was conducted. Poisson and logistic regression were used to calculate CPE rates and examine factors associated with CPE. RESULTS The rates of CPE are decreasing over time and are higher among Manitobans with an intellectual or developmental disability. Characteristics such as being male, living rurally, low socioeconomic status, and high continuity of care led to lower odds of receiving a CPE. CONCLUSIONS The current state of CPE provision to adults with intellectual or developmental disabilities in Manitoba is encouraging but needs improvement.
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Affiliation(s)
- Iresha Ratnayake
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Shahin Shooshtari
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Dan Chateau
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Mark Kristjanson
- Department of Family Medicine, University of Manitoba, Winnipeg, Canada
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