Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis
Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis
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DOI：
10.1186/s12875-015-0329-3
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发表时间：
2015-08-27
影响因子：
2.9
通讯作者：
Morrison, Jill
中科院分区：
文献类型：
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作者：
Cooper, Sally-Ann;McLean, Gary;Morrison, Jill
背景：与普通人群相比，智力障碍成年人的早期死亡率有所增加。然而，与一般人群相比，他们的多重发病率（两种或多种附加病症）的程度尚不清楚，特别是在身体健康状况不佳方面，以及合并症、邻里贫困和年龄之间的关联。 方法：我们分析了 1,424,378 名在 314 个具有代表性的苏格兰实践中登记的成年人的初级卫生保健数据。提取了智力障碍、32 种身体健康状况和 6 种心理健康状况的数据。我们按年龄组、性别和邻里剥夺情况生成了标准化患病率，然后计算了智障成年人与无智障成年人相比的比值比 (OR) 和 95% 置信区间 (95% CI)，了解患病率和疾病数量。 结果：8,14 名 (0.56%) 患有智力障碍，其中只有 31.8% 没有其他疾病，而没有智障的人为 51.6%（OR 0.26, 95）。 % 0.25-0.27)。智力障碍组明显更有可能患有更多病症，其中三种病症差异最大（10.9% 与 6.8%；OR 2.28，95% CI 2.10-2.46）。十四种身体状况明显更为普遍，四种心血管疾病的发生频率较低，任何癌症和慢性阻塞性肺病也是如此。六种心理健康状况中有五种明显更为普遍。对于智力障碍的成年人来说，随着邻里剥夺的增加，多重发病的程度没有出现梯度；事实上，在最富裕和最贫困的地区，调查结果是相似的。共病随着年龄的增长而增加，但在所有年龄段都非常普遍，在一般人群中，20-25 岁至 50-54 岁之间的情况相似。 结论：与一般人群相比，智力障碍成年人的多种发病负担更大，发生的年龄要早得多，而且健康状况的概况也不同。与邻里剥夺无关；智障人士无论居住在哪里，都需要有针对性的服务，而且他们的年龄比一般人群要早得多。他们需要采取具体举措来减少不平等。
Background: Adults 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.Methods: We 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.Results: Eight 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.Conclusions: Multi-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.