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İslamoğlu AH, Berkel G, Yildirim HS, Aktaç Ş, Bayram F, Sabuncular G, Güneş FE. Chewing difficulties, oral health, and nutritional status in adults with intellectual disabilities: A cross-sectional study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13225. [PMID: 38504582 DOI: 10.1111/jar.13225] [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: 10/09/2023] [Revised: 02/11/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Chewing difficulty, poor oral health, inadequate and imbalanced nutrition are serious health problems in individuals with intellectual disabilities. The participants' chewing abilities, oral health and nutritional status were analysed in this study. METHODS Forty-five adult participants with intellectual disabilities were included. Anthropometric measurements, oral health assessments, chewing ability evaluations and dietary intake analyses were conducted. RESULTS A 56.8% of the participants were classified as overweight or obese. Teeth grinding was reported in 33.3% of the participants, while 40.0% experienced drooling. All participants with Down syndrome and 58.6% of the participants with developmental delay had chewing difficulties. Inadequate nutrient intake was observed and the fibre, vitamins B1, B3, B9, sodium, phosphorus and iron intakes were significantly lower than reference values in those with chewing difficulty (p < .05). CONCLUSIONS Chewing difficulties were associated with lower intake of certain nutrients, highlighting the importance of addressing oral health and dietary counselling in this population.
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Affiliation(s)
- Ayşe Hümeyra İslamoğlu
- Department of Nutrition and Dietetics, Marmara University, Faculty of Health Sciences, İstanbul, Türkiye
| | - Gülcan Berkel
- Department of Oral and Maxillofacial Surgery, Marmara University, Faculty of Dentistry, Clinical Sciences, İstanbul, Türkiye
| | - Hatice Selin Yildirim
- Department of Periodontics, Marmara University, Faculty of Dentistry, Clinical Sciences, İstanbul, Türkiye
| | - Şule Aktaç
- Department of Nutrition and Dietetics, Marmara University, Faculty of Health Sciences, İstanbul, Türkiye
| | - Ferit Bayram
- Department of Oral and Maxillofacial Surgery, Marmara University, Faculty of Dentistry, Clinical Sciences, İstanbul, Türkiye
| | - Güleren Sabuncular
- Department of Nutrition and Dietetics, Marmara University, Faculty of Health Sciences, İstanbul, Türkiye
| | - Fatma Esra Güneş
- Department of Nutrition and Dietetics, İstanbul Medeniyet University, Faculty of Health Sciences, İstanbul, Türkiye
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Herrera-Quintana L, Vázquez-Lorente H, Carranco Romo MJ, Flores Buitrón EP, Molina-López J, Moya MT, Planells E. Imbalanced dietary patterns, anthropometric, and body composition profiles amongst adults with Down syndrome. Nutr Neurosci 2024; 27:96-105. [PMID: 36579765 DOI: 10.1080/1028415x.2022.2161139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: We aimed to analyze the anthropometric and body composition profiles of Down syndrome (DS) adults; to describe their dietary habits, nutrient intake, and physical activity patterns; and to identify the related risk factors which may influence their health status and quality of life.Methods: A cross-sectional study was conducted on a cohort of 23 DS adults (45% women) aged 21-44 years. Anthropometry and body composition were assessed by bioelectrical impedance. Dietary nutrient intake was assessed quantitatively using a 72-h recall. A food frequency questionnaire and the prevention with Mediterranean diet-PREDIMED questionnaire were used for qualitative rating.Results: Higher fat mass (FM) and lower lean mass (LM), bone mass (BM), and waist to hip ratio (WHR) were observed in women compared to men. LM and BM decreased, and body mass index (BMI), FM, and WHR increased with aging (all P < 0.05). Vitamin D and iodine intakes were not met by 70% and 60% of the studied participants, respectively. A total of 82% of the participants consumed less than 5 portions of fruits and vegetables per day and overconsumed food groups such as sweets and snacks and red meat (> 2 times per week). Protein intake showed a significant positive correlation with height (r = 0.489, P < 0.05), whereas fat intake was positively correlated with sweets and snacks (r = 0.521, P < 0.05).Conclusion: The present findings support the existence of poor anthropometric and body composition profiles, and diet quality, underscoring the need for an interdisciplinary team assessment to enhance health and quality of life in DS adults.
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Affiliation(s)
- L Herrera-Quintana
- Department of Physiology, School of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain
| | - H Vázquez-Lorente
- Department of Physiology, School of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain
| | - M J Carranco Romo
- Department of Physiology, School of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain
| | - E P Flores Buitrón
- Department of Physiology, School of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain
| | - J Molina-López
- Faculty of Education, Psychology and Sports Sciences, University of Huelva, Huelva, Spain
| | - M T Moya
- GranaDown, Down Syndrome Association of Granada, Granada, Spain
| | - E Planells
- Department of Physiology, School of Pharmacy, Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain
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Valentin B, Maes-Festen D, Schoufour J, Oppewal A. Sarcopenia predicts 5-year mortality in older adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1161-1173. [PMID: 37608512 DOI: 10.1111/jir.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/06/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) have a lower life expectancy than their peers without ID. A contributing factor to the lower life expectancy and early mortality could be sarcopenia: low muscle mass and low muscle function. In the general population, sarcopenia strongly predicts early mortality, but this association is unknown in people with ID. Therefore, this study aims to explore the association between sarcopenia and 5-year mortality in older adults with ID. METHODS In the Healthy Ageing and Intellectual Disabilities (HA-ID) study, the prevalence of sarcopenia was measured at baseline among 884 older adults (≥50 years) with ID. All-cause mortality was measured over a 5-year follow-up period. Univariable and multivariable Cox proportional hazard models were applied to determine the association between sarcopenia (no sarcopenia, pre-sarcopenia, sarcopenia, severe sarcopenia) and early mortality, adjusted for age, sex, level of ID, presence of Down syndrome, and co-morbidity (chronic obstructive pulmonary disease, diabetes type 2 and metabolic syndrome). RESULTS The unadjusted hazard ratio (HR) for sarcopenia was 2.28 [95% confidence interval (CI) 1.48-3.42], P < 0.001), and 2.40 (95% CI 1.40-4.10, P = 0.001) for severe sarcopenia. When adjusted for age, sex, level of ID, and Down syndrome, sarcopenia (HR = 1.72, 95% CI 1.08-2.75, P = 0.022) and severe sarcopenia (HR = 1.86, 95% CI 1.07-3.23, P = 0.028) were significantly associated with early mortality. When additionally adjusted for co-morbidity, the adjusted HR decreased to 1.62 (95% CI 1.02-2.59, P = 0.043) and 1.81 (95% CI 1.04-3.15, P = 0.035) for sarcopenia and severe sarcopenia, respectively. CONCLUSION Sarcopenia is an independent risk factor for early mortality in older adults with ID over a 5-year follow-up period. Our results stress the need to delay the incidence and development of sarcopenia in older adults with ID.
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Affiliation(s)
- B Valentin
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Faculty of Sports and Nutrition, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - D Maes-Festen
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J Schoufour
- Faculty of Sports and Nutrition, Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - A Oppewal
- Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Jacinto M, Matos R, Monteiro D, Antunes R, Caseiro A, Gomes B, Campos MJ, Ferreira JP. Effects of a 24-week exercise program on anthropometric, body composition, metabolic status, cardiovascular response, and neuromuscular capacity, in individuals with intellectual and developmental disabilities. Front Physiol 2023; 14:1205463. [PMID: 37288435 PMCID: PMC10242032 DOI: 10.3389/fphys.2023.1205463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/28/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction: The prevalence of overweight and obesity has increased in the last decades, including in people with Intellectual and Developmental Disabilities (IDD). This is even more concerning when it is globally accepted that a low physical condition contributes to the deterioration of functionality and increases the risk of developing chronic diseases during life, with effective implications for health and well-being. The aim of the present study is to investigate the effects of two physical exercise intervention programs on institutionalized individuals with IDD. Methods: Twenty-one adults with IDD (43.04 ± 11.18 years) were split by convenience into three groups: i) an indoor training group (IG; N = 7; 24-week machine-based gym intervention), ii) an outdoor training group (OG; N = 7; 24-week outdoor intervention with low-content materials), and iii) a control group (CG; N = 7). Assessed outcomes included indicators of health and neuromuscular capacity. The ShapiroWilk (n < 50) and Levene tests were used to verify data normality and homoscedasticity. A Kruskal-Walli test was performed to understand if there were differences between the groups. For comparison purposes and to assess hypothetical differences between groups, the Wilcoxon signed-rank test and the Friedman test were used. The respective effect size was calculated, and the significance level was defined at 0.05. Results/Discussion: There was a difference in fat mass in OG (initial ≠ intermediate; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08 and initial ≠ final moments; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08). Indoor intervention programs seem to be more effective than outdoor intervention programs for reducing heart rate rest (t = -2.912; p = 0.011; W = -0.104) when compared with CG. Conclusion: A low-cost outdoor intervention in contact with nature appears to be more effective for fat mass reduction. The results for heart rate variability are not clear and robust. Finally, an indoor intervention using weight-training machines appears to be a good method to promote neuromuscular capacity.
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Affiliation(s)
- Miguel Jacinto
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Rui Matos
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Diogo Monteiro
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Raul Antunes
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - André Caseiro
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Beatriz Gomes
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - Maria João Campos
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - José Pedro Ferreira
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
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Salomon C, Bellamy J, Evans E, Reid R, Hsu M, Teasdale S, Trollor J. 'Get Healthy!' physical activity and healthy eating intervention for adults with intellectual disability: results from the feasibility pilot. Pilot Feasibility Stud 2023; 9:48. [PMID: 36949532 PMCID: PMC10032022 DOI: 10.1186/s40814-023-01267-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/27/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND People with intellectual disabilities (ID) experience high rates of lifestyle related morbidities, in part due to lack of access to tailored health promotion programmes. This study aimed to assess the feasibility and preliminary efficacy of a tailored healthy lifestyle intervention, Get Healthy! METHODS Get Healthy! is a 12-week physical activity and healthy eating programme designed to address lifestyle-related risks for adults with mild-moderate ID. The feasibility pilot was designed to assess subjective participant experience and programme feasibility across: recruitment and screening, retention, session attendance and engagement, adverse events, and practicality and reliability of outcome procedures. Exploratory programme efficacy was assessed across the following measures: anthropometry (body mass index, weight, waist circumference), cardiovascular fitness, physical strength, dietary intake, healthy literacy, and quality of life. RESULTS Six participants with moderate ID and two carer participants completed the feasibility trial, representing a 100% retention rate. Qualitative data indicated the programme was well received. Participants with ID attended 75% of sessions offered and displayed a high level of engagement in sessions attended (91% mean engagement score). While most data collection procedures were feasible to implement, several measures were either not feasible for our participants, or required a higher level of support to implement than was provided in the existing trial protocol. Participants with ID displayed decreases in mean waist circumference between baseline and endpoint (95% CI: - 3.20, - 0.17 cm) and some improvements in measures of cardiovascular fitness and physical strength. No changes in weight, body mass index, or objectively measured knowledge of nutrition and exercise or quality of life were detected from baseline to programme endpoint. Dietary intake results were mixed. DISCUSSION The Get Healthy! programme was feasible to implement and well received by participants with moderate ID and their carers. Exploratory efficacy data indicates the programme has potential to positively impact important cardiometabolic risk factors such as waist circumference, cardiovascular fitness, and physical strength. Several of the proposed data collection instruments will require modification or replacement prior to use in a sufficiently powered efficacy trial. TRIAL REGISTRATION ACTRN: ACTRN12618000349246. Registered March 8th 2018-retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374497 UTN: U1111-1209-3132.
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Affiliation(s)
- Carmela Salomon
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia
| | - Jessica Bellamy
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia
- School of Medical, Indigenous & Health Sciences, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, 2522, Australia
| | - Elizabeth Evans
- Council for Intellectual Disability, 418A Elizabeth St, Surry Hills, NSW, 2010, Australia
| | - Renae Reid
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia
| | - Michelle Hsu
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, The University of Sydney, Sydney, 2006, Australia
| | - Scott Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, 26 Llandaff Street Bondi Junction, Sydney, 2022, Australia
- Discipline of Psychiatry and Mental Health, UNSW Sydney, Kensington, Australia
| | - Julian Trollor
- Department of Developmental Disability Neuropsychiatry, UNSW Sydney, Room 241, Level 2, Biolink Building E25, Sydney, NSW, 2052, Australia.
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Højberg LM, Helge EW, Pingel J, Wienecke J. The Health Effects of 14 Weeks of Physical Activity in a Real-Life Setting for Adults with Intellectual Disabilities. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:6817318. [PMID: 38655171 PMCID: PMC11022770 DOI: 10.1155/2022/6817318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 04/26/2024]
Abstract
Background The life expectancy of individuals with intellectual disabilities (ID) is reduced compared to the general population, and one of the main contributors to earlier death is inactivity. Aim To investigate how 14 weeks of physical activity (PA) in a real-life setting affects cardiovascular fitness, body composition and bone health of adults with ID. Methods Adults with ID were recruited into a PA-group (N = 52) or a control group (CON, N = 14). The PA-group participated in 14 weeks of PA, and body composition, cardiovascular fitness and bone health were assessed before and after the intervention. Outcomes and Results. Cardiovascular fitness and body composition improved from pre to post within the PA-group: Heart rates (HR) during the last 30 seconds of two increments of a treadmill test, were reduced (3.2 km/h: -4.4 bpm, p < 0.05; 4.8 km/h: -7.5 bpm, p < 0.001) and fat mass was reduced (-1.02 kg, p < 0.05). A between-group difference in favour of the PA-group, were observed in whole body bone mineral density (BMD) (0.024 g/cm2, p < 0.05). Conclusions and Implications. Fourteen weeks of PA performed in a real-life setting increased cardiovascular fitness, reduced fat mass and improved BMD in the weight-bearing skeleton in the PA-group. Increased and regular PA seems to be a promising tool to promote physical health in adults with ID.
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Affiliation(s)
- Laurits Munk Højberg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Eva Wulff Helge
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Pingel
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Wienecke
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
- Department of Sport and Social Sciences, Norwegian School of Sport Science, Oslo, Norway
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Gomez-Hixson K, Batista N, Brown M. Retrospective analysis of the Special Olympics Health Promotion database for nutrition-specific variables. Heliyon 2021; 7:e08586. [PMID: 34917831 PMCID: PMC8669299 DOI: 10.1016/j.heliyon.2021.e08586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/12/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Studies have shown that individuals with intellectual disabilities (ID) exhibit a high prevalence of obesity and poor-quality diet. The population of individuals with ID include athletes that participate in Special Olympics. AIM In order to develop appropriate educational programs for the Special Olympics Athletes in Connecticut, a baseline of the various health and nutrition variables needed to be established by examining the existing data in the Special Olympics International's Health Promotion database. METHODS A retrospective analysis was performed using data from the Special Olympics International (SOI) Health Promotion database. The study population included athletes at least 20 years of age (n = 47,932) and divided into sub-groups of non-USA, USA and Connecticut (CT). The data was provided by SOI to the research team in a de-identified form covering the time frame of 2014-2019. The existing data was originally collected by trained SO volunteers and included age, height, weight, bone mineral density (BMD), blood pressure (BP) variables and a health habits questionnaire. In addition to basic descriptive statistics, analysis was performed using Chi Squared Analysis and ANOVA with post-hoc. A significance level of p value ≤ 0.05 was used for all analyses. RESULTS Results show a high prevalence of obesity, high blood pressure, low bone mineral density and a poor-quality diet across all groups. CT athletes were older and had a more even distribution by gender compared to the non-USA and USA groups. CT athletes had a high prevalence of obesity, HTN, and low BMD, as well as, a poor quality diet reflected by high frequency of consumption of sweetened beverages, fast food and snack food. CT athletes also did not consume the recommended daily servings of calcium containing foods or fruits and vegetables. CONCLUSION This data will be used to develop educational programs that will help to improve the overall health of Special Olympics Athletes in Connecticut.
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Affiliation(s)
- Kaneen Gomez-Hixson
- University of Saint Joseph, Department of Nutrition and Public Health, 1678 Asylum Ave., West Hartford, CT, 06117, USA
| | - Nicole Batista
- Special Olympics Connecticut, 2666 State Street Suite 1, Hamden, CT, 06517, USA
| | - Melissa Brown
- University of Saint Joseph, Department of Nutrition and Public Health, 1678 Asylum Ave., West Hartford, CT, 06117, USA
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Gast DAA, de Wit GLC, van Hoof A, de Vries JHM, van Hemert B, Didden R, Giltay EJ. Diet quality among people with intellectual disabilities and borderline intellectual functioning. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:488-494. [PMID: 34704323 PMCID: PMC9298221 DOI: 10.1111/jar.12958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 11/29/2022]
Abstract
Background We sought to assess diet quality among people with intellectual disabilities or borderline intellectual functioning, living in residential facilities or receiving day care. Methods We measured diet quality using the Dutch Healthy Diet Food Frequency Questionnaire (DHD) and compared this between participants with (n = 151) and controls without intellectual disabilities (n = 169). Potential correlates of diet quality were explored. Results We found lower mean diet quality among people with intellectual disabilities (M = 80.9) compared to controls (M = 111.2; mean adjusted difference −28.4; 95% CI [−32.3, −24.5]; p < .001). Participants with borderline intellectual functioning and mild intellectual disabilities had lower diet quality and higher body mass index than individuals with severe to profound intellectual disabilities. Being female was a predictor of better diet quality. Conclusions Overall, we found that diet quality was low in the sample of people with intellectual disabilities or borderline intellectual functioning.
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Affiliation(s)
- David A A Gast
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands.,Gemiva-SVG Group, Gouda, The Netherlands
| | - Gabriela L C de Wit
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Amber van Hoof
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Jeanne H M de Vries
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Bert van Hemert
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands
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Doody O, Bailey ME, Hennessy T. Nature and extent of intellectual disability nursing research in Ireland: a scoping review to inform health and health service research. BMJ Open 2021; 11:e051858. [PMID: 34615681 PMCID: PMC8496393 DOI: 10.1136/bmjopen-2021-051858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To capture the extent and nature of intellectual disability nursing publications in Ireland. DESIGN Scoping review using Arksey and O'Malley approach. DATA SOURCES Six databases (PsycINFO, CINAHL, Medline, Academic Search Complete, Scopus, Embase) were searched along with a web-based search of the eight academic institutions delivering intellectual disability nurse education in Ireland for publications indexed from the earliest available date to the 31 December 2020. ELIGIBILITY CRITERIA Publications by an academic, practitioner or student working in intellectual disability practice or education in Ireland relating to intellectual disability nursing, care or education. DATA EXTRACTION AND SYNTHESIS Data pertaining to type of paper/design, authors (academic/professional/student), year, collaboration (national/international), topic/content area and title were extracted from each paper. Data were analysed by two authors using Colorafi and Evans content analysis steps where data was tabulated, and a narrative synthesis undertaken. RESULTS The reporting of the review is in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and PRISMA extension for Scoping Reviews Checklist. Database and web-based searching resulting 245 articles meeting the criteria for this review. Through content analysis the 245 articles were mapped onto six themes: supporting inclusion, future planning, aspects of health, interventions, education, professional development and research, and personal and professional accounts of caring. CONCLUSIONS This review highlights the extent and nature of intellectual disability publications by academic, practitioner or student working in intellectual disability nursing in Ireland together with opportunities for future growth and development. From the findings it is apparent that there is an ongoing need for intellectual disability nurses to define their role across the full trajectory of health provision and to make visible their role in person-family centred support, inclusion, and contributions in health education, health promotion and health management.
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Affiliation(s)
- Owen Doody
- Nursing and Midwifery, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Maria E Bailey
- Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Therese Hennessy
- Nursing and Midwifery, University of Limerick, Limerick, Ireland
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Skrzypek M, Koch W, Goral K, Soczyńska K, Poźniak O, Cichoń K, Przybysz O, Czop M. Analysis of the Diet Quality and Nutritional State of Children, Youth and Young Adults with an Intellectual Disability: A Multiple Case Study. Preliminary Polish Results. Nutrients 2021; 13:nu13093058. [PMID: 34578938 PMCID: PMC8470530 DOI: 10.3390/nu13093058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Considering the limited amount of available data on the diet quality of children, adolescents, and young adults with an intellectual disability (ID) in Poland, as well as the higher incidence of nutritional disorders among people with ID in comparison to the general population, a study was conducted to assess the quality of diet in community-dwelling young individuals with ID. (2) Methods: A multiple-case study was carried out to obtain data on anthropometric parameters and food records over a three-day observation period for 18 subjects with ID. The nutritional value of the products and dishes consumed by the subjects was calculated using the commercial computer program Kcalmar.pro (Hermax, Poland), which contains the Polish database of the nutritional value of food products and dishes. The results presented here are those of a pilot study of a wider research project. (3) Results: The study group consisted of seven women (38.9%) and 11 men (61.1%) with an average age of 12.94 years (range 4.00-22.00) and an average BMI of 25.2 (range 14.5-35.4). The obtained results confirmed the suboptimal pattern of nutrition in children and adolescents with ID. Regarding energy intake and dietary macronutrients, only in 27.8% of cases, energy intake exceeded the Estimated Energy Requirement corresponding to age, sex, body weight, and height. Most of the respondents were characterized by correct intake of proteins, fats, and carbohydrates, and 83.3% showed excessive intake of saturated fatty acids. Excessive intake of vitamins B1, B2, and B6 was observed in all subjects, and that of vitamins B3 (niacin), B12, A, and C in the vast majority of subjects, while deficiency of vitamin D was observed in all individuals and folic acid in 22.2% of individuals. Excessive intake of minerals, such as sodium, phosphorus, and magnesium was noted among most of the respondents, while the intake of calcium and iodine was found to be insufficient. Compared to people with less severe ID (grades 1 and 2), people with grade 3 ID showed significantly lower intake/reference fulfillment of dietary components such as vitamin B6, potassium, phosphorus, iron, copper, iodine, magnesium, and zinc. No significant differences were noted in the nutritional reference fulfillment for various nutrients among the groups distinguished by sex, nutritional status, or the cause of ID. (4) Conclusion: Health supervision guidelines proposed for persons with ID should take into account the dietary practices of the families caring for them, with an emphasis on the prevention and correction of irregularities that may reduce the effectiveness of rehabilitation and deteriorate the health of the affected people. Caregivers/parents of each person with ID who took part in the study were given individualized dietary advice aimed at correcting the dietary abnormalities.
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Affiliation(s)
- Michał Skrzypek
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
- Correspondence: (M.S.); (W.K.)
| | - Wojciech Koch
- Department of Food and Nutrition, Medical University of Lublin, Chodźki 4a Street, 20-093 Lublin, Poland
- Correspondence: (M.S.); (W.K.)
| | - Karolina Goral
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Klaudia Soczyńska
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Olga Poźniak
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Klaudia Cichoń
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Olga Przybysz
- Department of Clinical Dietetics, Medical University of Lublin, Chodźki 1 Street, 20-093 Lublin, Poland; (K.G.); (K.S.); (O.P.); (K.C.); (O.P.)
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, Radziwiłłowska 11 Street, 20-080 Lublin, Poland;
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Harper L, Ooms A, Tuffrey Wijne I. The impact of nutrition on sleep in people with an intellectual disability: An integrative literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1393-1407. [PMID: 34212459 DOI: 10.1111/jar.12911] [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: 12/05/2020] [Revised: 04/25/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with intellectual disabilities are more likely to experience sleep problems. Sleep can impact on health and well-being; therefore, evidence-based interventions are required to improve sleep in this population. METHOD An integrative literature review was conducted on the impact of nutrition on sleep in people with intellectual disabilities. Following screening of papers (n = 289), 14 papers met the inclusion criteria. RESULTS Themes related to nutrition and improved overall well-being, use of nutritional supplements, specific foods, links to health comorbidities and food fussiness. CONCLUSION This is the first comprehensive review completed on nutritional interventions to improve sleep in people with intellectual disabilities. Dietary patterns may be an important factor to improving the quality and quantity of sleep. However, the current literature regarding the benefit of improved nutrition on sleep in people with an intellectual disability needs to be interpreted with caution.
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Affiliation(s)
- Lynette Harper
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Ann Ooms
- Kingston University and St Georges University, London, UK
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Sedentary Time, Physical Activity Levels and Physical Fitness in Adults with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095033. [PMID: 34068668 PMCID: PMC8126167 DOI: 10.3390/ijerph18095033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 12/29/2022]
Abstract
Purpose: This cross-sectional study assessed the associations of gender, age, level of intellectual disabilities (IDs) and of daily sedentary and physical activity (PA) time with physical fitness in adults with ID. Materials and methods: Sixty adults (mean age = 39.19 ± 11.70 years) with ID participated in this cross-sectional study. PA was monitored for 7 days using an ActiGraph GT3X monitor. Physical fitness was measured with a 6-min walking test, isometric push-up test, modified curl-up test, handgrip strength test, and back-saver sit-and-reach test. Results: (a) An age of ≥39 years and female gender were associated with lower performance in multiple aspects of physical fitness. (b) More moderate-to-vigorous PA (MVPA) was associated with greater muscular strength and endurance (modified curl-ups: β = 0.36, p < 0.01; handgrip strength: right, β = 0.52, p < 0.01; left, β = 0.52, p < 0.01). (c) More light-intensity PA (LPA) was associated with greater upper-body muscular endurance (β = 0.42, p < 0.01) and greater flexibility (right leg: β = 0.36, p < 0.01; left leg: β = 0.38, p < 0.01). Conclusion: LPA may be as beneficial as MVPA to the physical fitness of adults with ID. Future studies should focus on developing effective PA interventions for adults with ID, especially for women and individuals aged ≥39 years, by incorporating both LPA and MVPA.
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Taggart L, Doherty AJ, Chauhan U, Hassiotis A. An exploration of lifestyle/obesity programmes for adults with intellectual disabilities through a realist lens: Impact of a 'context, mechanism and outcome' evaluation. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:578-593. [PMID: 33342030 DOI: 10.1111/jar.12826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 07/16/2020] [Accepted: 10/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obesity is higher in people with intellectual disabilities. AIMS There are two aims of this explorative paper. Firstly, using a realist lens, to go beyond 'what works' and examine the 'context, mechanisms and outcomes' (CMO) of lifestyle/obesity programmes for this population. Second, using a logic model framework to inform how these programmes could be implemented within practice. METHOD We explored six-review papers and the individual lifestyle/obesity programmes that these papers reviewed using the CMO framework. RESULTS There were few theoretically underpinned, multi-component programmes that were effective in the short to long-term and many failed to explore the 'context and mechanisms'. We developed a logic model and engaged in two co-production workshops to refine this model. DISCUSSION Using a realist approach, programmes need to be underpinned by both individual and systems change theories, be multi-component, have a closer understanding of the interplay of the 'context and mechanisms', and co-designed using a logic model framework.
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Affiliation(s)
- Laurence Taggart
- Institute of Nursing & Health Research, Ulster University, Co Antrim, UK
| | - Alison Jayne Doherty
- Faculty of Health & Wellbeing, University of Central Lancashire (UCLan), Preston, UK
| | - Umesh Chauhan
- Faculty of Health & Wellbeing, University of Central Lancashire (UCLan), Preston, UK
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Parma B, Cianci P, Decimi V, Mariani M, Provero MC, Funari C, Tajè S, Apuril E, Cereda A, Panceri R, Maitz S, Fossati C, Selicorni A. Complex nutritional deficiencies in a large cohort of Italian patients with Cornelia de Lange syndrome spectrum. Am J Med Genet A 2020; 182:2094-2101. [PMID: 32648352 DOI: 10.1002/ajmg.a.61749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 01/09/2023]
Abstract
Cornelia de Lange syndrome Spectrum (CdLSp) is characterized by intellectual disability, facial dysmorphisms, and growth impairment. Although eating difficulties are a well-known feature of the disease, there is no data regarding the nutritional deficiencies of these patients. The food intake was tracked using a dietary transcription provided by the family/caregivers, biochemical nutritional parameters were measured with laboratory tests and through an accurate clinical evaluation of the incidence of qualitative and quantitative imbalances in a cohort of 73 patients with CdLSp ware determined. Of these 73, 62 (85%) subjects provided a complete and detailed dietary transcription. In the studied population, a quantitative caloric imbalance in 47/62 (76%) subjects was observed. The caloric intake was low in 27/62 (43%) subjects whereas excessive in 20/62 (33%). Only 15/62 (24%) had an optimum caloric intake. Regarding micronutrients, a calcium intake deficiency in 32% of the patients (20/62) was observed. Blood tests revealed a low iron level in 22/73 (30%) of the patients and 25(OH)D deficiency in 49/73 (67%). Serum hypocalcemia was not evidenced. Qualitative and quantitative imbalances resulted in more frequent than expected in CdLSp patients. A qualitative imbalance was more prevalent in younger patients while in older patients prevailed mainly a quantitative disproportion. We found no statistically meaningful correlation between dietary imbalances, genetic, or clinical parameters. Our findings highlight the need for further studies to evaluate the basal metabolic rate of CdLSp patients and find a correlation with their growth impairment.
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Affiliation(s)
- Barbara Parma
- Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy
| | - Paola Cianci
- Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy
| | | | - Milena Mariani
- Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy
| | | | - Caterina Funari
- Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy
| | - Silvia Tajè
- Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy
| | - Erika Apuril
- Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy
| | - Anna Cereda
- Department of Pediatrics, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Roberto Panceri
- Department of Pediatrics, San Gerardo Hospital, Monza, Italy
| | - Silvia Maitz
- Department of Pediatrics, San Gerardo Hospital, Monza, Italy
| | - Chiara Fossati
- Department of Pediatrics, San Gerardo Hospital, Monza, Italy
| | - Angelo Selicorni
- Department of Pediatrics, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia (Como), Italy
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Tyrer F, Ling S, Bhaumik S, Gangadharan SK, Khunti K, Gray LJ, Dunkley AJ. Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:287-295. [PMID: 31976599 DOI: 10.1111/jir.12718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 10/01/2019] [Accepted: 01/13/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND As people with intellectual disabilities (ID) are now living longer, they are more at risk of developing non-communicable diseases, including type 2 diabetes mellitus. However, understanding of factors associated with diabetes for targeted management and prevention strategies is limited. This study aimed to investigate prevalence of diabetes in adults (aged ≥18 years) with ID and its relationship with demographic, lifestyle, independence and health factors. METHOD This was a cross-sectional analysis of interview data from 1091 adults with ID from the Leicestershire Learning Disability Register from 1 January 2010 to 31 December 2016. Logistic regression models were used to identify factors associated with diabetes in the study population. RESULTS The study population did not have healthy lifestyles: just under half reported having lower physical activity levels than people without ID of a similar age; one-quarter consumed fizzy drinks daily; and 20% consumed five or more fruit and/or vegetables per day. Prevalence of carer/self-reported diabetes was 7.3% (95% confidence interval 5.9-9.0). After adjustment, diabetes was positively associated with South Asian ethnicity (P = 0.03) and older age groups (P < 0.001). Diabetes was less common in people living with family members (P = 0.02). We did not find a relationship between any of the lifestyle, independence and health factors investigated. CONCLUSIONS A significant proportion of people with ID are living with diabetes. Diabetes management and prevention strategies should be tailored to individuals' complex needs and include consideration of lifestyle choices. Such strategies may want to focus on adults of South Asian ethnicity and people living in residential homes where prevalence appears to be higher.
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Affiliation(s)
- F Tyrer
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, University of Leicester, Leicester, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - S Ling
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, University of Leicester, Leicester, UK
| | - S Bhaumik
- Learning Disability Services, Leicestershire Partnership NHS Trust, Leicester, UK
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - S K Gangadharan
- Learning Disability Services, Leicestershire Partnership NHS Trust, Leicester, UK
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- Leicester Real World Evidence Unit, University of Leicester, Leicester, UK
| | - L J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - A J Dunkley
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Emerson E, Savage A, Llewellyn G. Prevalence of underweight, wasting and stunting among young children with a significant cognitive delay in 47 low-income and middle-income countries. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:93-102. [PMID: 31845425 DOI: 10.1111/jir.12698] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Undernutrition in early childhood is associated with a range of negative outcomes across the lifespan. Little is known about the prevalence of exposure to undernutrition among young children with significant cognitive delay. METHOD Secondary analysis of data collected on 161 188 three- and four-year-old children in 47 low-income and middle-income countries in Rounds 4-6 of UNICEF's Multiple Indicator Cluster Surveys. Of these, 12.3% (95% confidence interval 11.8-12.8%) showed evidence of significant cognitive delay. RESULTS In both middle-income and low-income countries, significant cognitive delay was associated with an increased prevalence of exposure to three indicators of undernutrition (underweight, wasting and stunting). Overall, children with significant cognitive delay were more than twice as likely than their peers to be exposed to severe underweight, severe wasting and severe stunting. Among children with significant cognitive delay (and after controlling for country economic classification group), relative household wealth was the strongest and most consistent predictor of exposure to undernutrition. CONCLUSIONS Given that undernutrition in early childhood is associated with a range of negative outcomes in later life, it is possible that undernutrition in early childhood may play an important role in accounting for health inequalities and inequities experienced by people with significant cognitive delay in low-income and middle-income countries.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - A Savage
- Family and Disability Studies Initiative, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - G Llewellyn
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Corby D, Sweeney MR. Researchers' experiences and lessons learned from doing mixed-methods research with a population with intellectual disabilities: Insights from the SOPHIE study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2019; 23:250-265. [PMID: 29246083 DOI: 10.1177/1744629517747834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Researchers are challenged to provide opportunities for people with intellectual disabilities (IDs) and their families to become participants in research. This article explores the processes and procedures involved in conducting a mixed-methods study. The preparation for the study is described and explained. Recruitment is examined by describing the process and analysing phone calls made to potential participants. Reflections of research team members help to develop the analysis and contribute to a discussion of the fieldwork. Lessons learned show that research projects involving people with IDs and their families need careful planning and have additional costs. The research team requires a mix of expertise. Traditional recruitment methods may not be suitable, and researchers need to build good relationships with gatekeepers so that participants can be contacted directly. Good quality research with people with IDs and their families is possible once suitable strategies are employed throughout the research process.
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Perampanel-induced weight gain depends on level of intellectual disability and its serum concentration. Epilepsy Res 2019; 152:1-6. [PMID: 30852339 DOI: 10.1016/j.eplepsyres.2019.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/28/2019] [Accepted: 02/24/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Body weight (BW) gain may be induced by perampanel (PER) administration, similar to the well-known adverse effects of valproic acid and gabapentin. Intellectual disability (ID) and serum PER concentration may be risk factors of BW gain. PURPOSE This study investigated how ID and serum PER concentration are associated with PER-induced BW gain. METHODS Subjects were 76 patients with epilepsy (41 men, aged 16-70 years). All patients were divided by intelligence quotient (IQ) into no ID (IQ ≥ 70, n = 24), mild to moderate ID (70 > IQ ≥35, n = 31), and severe to profound ID (IQ < 35, n = 21) groups. BW was measured before and 2, 4, 6, and 12 months after initiation of PER treatment, and serum PER concentration at 12 months. RESULTS BW gains in the mild to moderate ID group at 4, 6, and 12 months were significantly (p < 0.05) higher than in the no ID and in the severe to profound ID groups. At 12 months, BW gain was associated with serum PER concentrations in the no ID (p = 0.034) and the mild to moderate ID (p = 0.001) groups but not in the severe to profound ID group. Multiple linear regression analysis found BW gain at 12 months was positively correlated with the mild to moderate ID group (β = 0.373, p = 0.002) and serum PER concentration (β = 0.241, p = 0.047). CONCLUSIONS The mild to moderate ID group gained more BW than the no ID group, suggesting that PER-induced food intake was greater due to weaker behavioral control in the mild to moderate ID group. The present study suggests a linear correlation between serum PER concentration and BW change.
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Harris L, Hankey C, Jones N, Murray H, Pert C, Tobin J, Boyle S, Shearer R, Melville CA. Process evaluation of a cluster-randomised controlled trial of multi-component weight management programme in adults with intellectual disabilities and obesity. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:49-63. [PMID: 30417575 DOI: 10.1111/jir.12563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/10/2018] [Accepted: 09/27/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Providing effective weight management to adults with intellectual disabilities is necessary to challenge the high rates of obesity. The aim of this process evaluation was to explore the feasibility of conducting a full-scale clinical trial of the TAKE 5 multi-component weight management programme. METHODS The study was a 12-month pilot cluster-randomised controlled trial. Adults with intellectual disabilities and obesity were randomised to either TAKE 5, which included an energy deficit diet (EDD) or Waist Winners Too, based on health education principles. A mixed-methods process evaluation was conducted focussing on the reach, recruitment, fidelity, implementation, dose (delivered/received) and context. RESULTS The study successfully recruited adults with intellectual disabilities. Both weight management programmes were delivered with high fidelity and implemented as intended. Only one weight management programme, TAKE 5, demonstrated potential efficacy in reducing body weight and body composition. The effectiveness was largely attributed to the EDD and social support from carers. CONCLUSIONS The extensive process evaluation illustrated that a full-scale trial of a multi-component programme including an EDD is feasible and an acceptable approach to weight management for adults with intellectual disabilities and obesity.
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Affiliation(s)
- L Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Hankey
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Jones
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - H Murray
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Pert
- Learning Disability Psychology, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - J Tobin
- Glasgow City CHP North East Sector, Eastbank Conference Training Centre, Glasgow, UK
| | - S Boyle
- Consultant Clinical Psychologist NHS Greater, Glasgow, UK
| | - R Shearer
- Glasgow and Clyde Specialist Weight Management Service, Glasgow, UK
| | - C A Melville
- College of Medical Veterinary and Life Sciences, Institute of Mental Health and Wellbeing, University of Glasgow, Glasgow, UK
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Iwaki H, Jin K, Fujikawa M, Nakasato N, Kaneko S. Topiramate-induced weight loss depends on level of intellectual disability in patients with epilepsy. Epilepsy Behav 2018; 83:87-91. [PMID: 29665571 DOI: 10.1016/j.yebeh.2018.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/04/2018] [Accepted: 03/04/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Intellectual disability (ID) is associated with weight gain caused by antiepileptic drugs such as valproic acid. The present study analyzed the relationship between ID and weight loss caused by topiramate (TPM). METHODS Seventy-eight patients with epilepsy (35 women, aged 18 to 70years) were enrolled in this prospective study. Body weight was measured before and 1, 6, 12, and 18months after initiation of TPM treatment. Both patients and caregivers were provided information about TPM-related weight loss. The patients were divided into the group with no or mild ID (intelligence quotient >50) and the group with moderate to profound ID (intelligence quotient ≤50). RESULTS Body weight of both groups significantly decreased until 6months but stabilized after 12months. Weight loss at 6, 12, and 18months was significantly greater in the group with no or mild ID than in the group with moderate to profound ID. Body weight change at 18months was correlated with intellectual levels (β=0.274, p=0.011) and baseline body mass index (β=-0.322, p=0.002) by multiple linear regression analysis. CONCLUSIONS The present study suggests that the pattern of weight loss during TPM administration differs according to intellectual levels. Patients with ID maintained their body weight. Weight loss due to TPM might be weakened by caregiver control of food intake or inactivity.
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Affiliation(s)
- Hirotaka Iwaki
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; North Tohoku Epilepsy Center, Minato Hospital, Hachinohe, Aomori, Japan
| | - Kazutaka Jin
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Mayu Fujikawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Sunao Kaneko
- North Tohoku Epilepsy Center, Minato Hospital, Hachinohe, Aomori, Japan
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