Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis

BMC Family Practice

Research Article

Gary McLean¹  Stewart Mercer¹  Jill Morrison¹  Sally-Ann Cooper²  Bruce Guthrie³  Alex McConnachie⁴  Frank Sullivan⁵ 

[1] General Practice and Primary Care group, Institute of Health and Wellbeing, University of Glasgow, 1, Horselethill Road, G12 9LX,, Glasgow, UK;Mental Health and Wellbeing group, Institute of Health and Wellbeing, University of Glasgow, Administrative Building, Gartnavel Royal Hospital, 1055 Great Western Road, G12 0XH, Glasgow, UK;Quality, Safety and Informatics Research Group, Population Health Sciences Division, University of Dundee, Mackenzie Building Kirsty Semple Way, DD2 4BF, Dundee, UK;Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Level 11, Boyd Orr Building, University Avenue, G12 8QQ, Glasgow, UK;UTOPIAN FMTU, North York General Hospital, Department of Family & Community Medicine and Dalla Lana School of Public Health, University of Toronto, M2K 1E1, Toronto, ON, Canada;

关键词: Intellectual disabilities;    Mental retardation;    Multi-morbidity;    Physical health;    Mental health;    Inequalities;    Deprivation;   

DOI  :  10.1186/s12875-015-0329-3

 received in 2015-02-04, accepted in 2015-08-21,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAdults with intellectual disabilities have increased early mortality compared with the general population. However, their extent of multimorbidity (two or more additional conditions) compared with the general population is unknown, particularly with regards to physical ill-health, as are associations between comorbidities, neighbourhood deprivation, and age.MethodsWe analysed primary health-care data on 1,424,378 adults registered with 314 representative Scottish practices. Data on intellectual disabilities, 32 physical, and six mental health conditions were extracted. We generated standardised prevalence rates by age-groups, gender, and neighbourhood deprivation, then calculated odds ratio (OR) and 95 % confidence intervals (95 % CI) for adults with intellectual disabilities compared to those without, for the prevalence, and number of condition.ResultsEight thousand fourteen (0.56 %) had intellectual disabilities, of whom only 31.8 % had no other conditions compared to 51.6 % without intellectual disabilities (OR 0.26, 95 % 0.25–0.27). The intellectual disabilities group were significantly more likely to have more conditions, with the biggest difference found for three conditions (10.9 % versus 6.8 %; OR 2.28, 95 % CI 2.10–2.46). Fourteen physical conditions were significantly more prevalent, and four cardiovascular conditions occurred less frequently, as did any cancers, and chronic obstructive pulmonary diseases. Five of the six mental health conditions were significantly more prevalent. For the adults with intellectual disabilities, no gradient was seen in extent of multimorbidity with increasing neighbourhood deprivation; indeed findings were similar in the most affluent and most deprived areas. Co-morbidity increased with age but is highly prevalent at all ages, being similar at age 20–25 to 50–54 year olds in the general population.ConclusionsMulti-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs, for adults with intellectual disabilities compared with the general population. There is no association with neighbourhood deprivation; people with intellectual disabilities need focussed services irrespective of where they live, and at a much earlier age than the general population. They require specific initiatives to reduce inequalities.

【 授权许可】

CC BY   
© Cooper et al. 2015