Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation
Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation
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DOI：
10.1007/s11606-015-3509-x
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发表时间：
2016-01-01
影响因子：
5.7
通讯作者：
Davidson, Philip W.
中科院分区：
文献类型：
--
作者：
Fortuna, Robert J.;Robinson, Laura;Davidson, Philip W.
自闭症谱系障碍（ASD）儿童和青少年有许多众所周知的健康问题，但成人自闭症患者的健康状况仍不明确。为了检查成人自闭症患者的健康状况和功能状态，并确定不同年龄组中与健康和功能状态相关的因素，我们使用罗切斯特健康状况调查IV（RHSS - IV）这一经过验证的58项调查工具，收集了255名18至71岁成人自闭症患者的横断面数据。我们利用美国国家健康和营养检查调查以及国家健康访谈调查来提供普通人群中的患病率作为对照。与普通人群相比，18 - 29岁的年轻成人自闭症患者癫痫发作障碍（11.2%对1.4%；p = 0.002）、抑郁症（16.4%对6.4%；p = 0.007）、高血压（12.9%对6.3%；p = 0.05）和过敏（39.7%对8.4%；p < 0.001）的患病率明显更高。相比之下，年轻成人自闭症患者性传播疾病（STI）（0.9%对4.3%；p = 0.03）、吸烟（5.2%对31.9%；p < 0.001）和酗酒（0.9%对11.9%；p < 0.001）的比率要低得多。40岁及以上的成人自闭症患者与普通人群相比，癫痫发作障碍的比率也更高（29.2%对1.7%；p < 0.001），吸烟率更低（2.8%对24.5%；p < 0.001），酗酒率更低（1.4%对18.2%；p < 0.001）。在有记录智商分数的55%的参与者中，91%有智力残疾（智商<70）。在40岁及以上的年龄组中，只有54.2%在进食方面能够独立，43.0%在穿衣方面能够独立，43.1%在洗澡方面能够独立。较低的智商和抑郁症与较低的功能状态相关。成人自闭症患者癫痫发作障碍和抑郁症的患病率较高，但性传播疾病、吸烟和酗酒的比率较低。在我们的研究队列中，大多数老年成人自闭症患者在日常生活活动中需要一些帮助。
Children and adolescents with autism spectrum disorder (ASD) have many well-known health concerns, yet health conditions in adults with ASD remain poorly defined.To examine health conditions and functional status in adults with ASD and identify factors associated with health and functional status across age cohorts.We collected cross-sectional data from 255 adult subjects aged 18 to 71 years with ASD using the Rochester Health Status Survey IV (RHSS-IV), a 58-item validated survey instrument. We used the National Health and Nutritional Examination Survey and National Health Interview Survey to provide comparative prevalence rates in the general population.Compared to the general population, young adults aged 18-29 with ASD had a substantially higher prevalence of seizure disorder (11.2 % vs. 1.4 %; p = 0.002), depression (16.4 % vs. 6.4 %; p = 0.007), hypertension (12.9 % vs. 6.3 %; p = 0.05), and allergies (39.7 % vs. 8.4 %; p < 0.001). In contrast, young adults with ASD had considerably lower rates of sexually transmitted illness (STI) (0.9 % vs. 4.3 %; p = 0.03), tobacco use (5.2 % vs. 31.9 %; p < 0.001), and alcohol misuse (0.9 % vs. 11.9 %; p < 0.001). Adults 40 and over with ASD also had higher rates of seizure disorder (29.2 % vs. 1.7 %; p < 0.001), lower tobacco use (2.8 % vs. 24.5 %; p < 0.001), and lower alcohol misuse (1.4 % vs. 18.2 %; p < 0.001) compared to the general population. Amongst the 55 % of participants with a documented IQ score, 91 % had an intellectual disability (IQ < 70). Within the cohort aged 40 years old and older, only 54.2 % were independent with eating, 43.0 % independent with dressing, and 43.1 % independent with bathing. Lower IQ and depression were associated with lower functional status.Adults with ASD have a high prevalence of seizure disorders and depression, but low rates of STIs, tobacco use, and alcohol misuse. Within our cohort, the majority of older adults with ASD required some assistance with activities of daily living.