Mortality in adults with moderate to profound intellectual disability: a population‐based study

Journal of Intellectual Disability Research - Tập 51 Số 7 - Trang 520-527 - 2007
Freya Tyrer1, Lucy Smith1, Catherine W. McGrother1
1Dept. of Health Sciences, University of Leicester, Leicester, UK

Tóm tắt

AbstractBackground People with intellectual disability (ID) experience a variety of health inequalities compared with the general population including higher mortality rates. This is the first UK population‐based study to measure the extent of excess mortality in people with ID compared with the general population.Method Indirectly standardized all‐cause and disease mortality ratios (SMRs) and exact Poisson confidence intervals were calculated by age and sex for all adults, aged 20 years or over, with moderate to profound ID living in Leicestershire and Rutland, UK, between 1993 and 2005. The general population of Leicestershire and Rutland, which has a population of approximately 700 000 individuals in this age range, was used for comparison. To explore differences within the study population, overall SMRs were also calculated by presence of Down syndrome and last place of residence (city or county).Results Of 2436 adults identified, 409 (17%) died during 23 000 person‐years of follow‐up. Both all‐cause and disease‐specific mortality were around three times higher than the general population but varied considerably with age. The largest differences were observed in people in their twenties, where all‐cause mortality was almost nine times higher in men (SMR = 883; 95% CI = 560–1325) and more than 17 times higher in women (SMR = 1722; 95% CI = 964–2840). At a particular disadvantage were people with Down syndrome and women with ID living in the city.Conclusions The relatively high SMRs observed in young people and in women, particularly those living in inner city areas and with Down syndrome, deserve further investigation for possible explanations, including socio‐economic factors.

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Tài liệu tham khảo

Alborz A., 2004, From the Cradle to the Grave: A literature review of access to health care for people with learning disabilities across the lifespan

10.1192/bjp.170.6.502

10.1192/bjp.170.4.375

10.1046/j.1365-3016.2002.00430.x

Department of Health, 2001, Valuing People. A New Strategy for Learning Disability for the 21st Century. White Paper

10.1080/1366825021000029311

10.1111/j.1528-1157.1996.tb00533.x

Fryers T., 1984, The Epidemiology of Severe Intellectual Impairment – The Dynamics of Prevalence

10.1034/j.1399-0004.2002.620506.x

Heber R., 1959, A manual on terminology and classification in mental retardation, American Journal of Mental Deficiency, 64, 1

10.1192/bjp.176.1.26

Hollins S., 1998, Mortality in people with learning disability: risks, causes, and death certification findings in London, Developmental Medicine and Child Neurology, 40, 50, 10.1111/j.1469-8749.1998.tb15356.x

10.1017/S0033291700049175

Howells G., 1986, Are the medical needs of mentally handicapped adults being met?, Journal of the Royal College of General Practitioners, 36, 449

10.1001/archneur.1989.00520440031017

Lawrenson R., 1997, Trends in the need for services for people with learning disabilities: implications for primary care, Health Trends, 29, 37

10.1111/j.1365-2788.1997.tb00723.x

McGrother C. W., 1990, Recent trends in incidence, morbidity and survival in Down’s syndrome, Journal of Mental Deficiency Research, 34, 49

10.1108/13595474200100022

10.1016/j.seizure.2006.04.002

10.1111/j.1365-2788.1995.tb00573.x

10.1192/bjp.153.1.102

10.1046/j.1365-2648.2003.02522.x

Martindale A. M. E., 1988, Trends in the prevalence of severe mental handicap in Sheffield since 1960, Community Medicine, 10, 331

National Statistics(19932004)Mid‐year population estimates 1993–2004: Leicester Leicestershire and Rutland.Stationary Office London.

National Statistics(2001)Census Standard Tables 2001: Leicester Leicestershire and Rutland.Stationary Office London.

10.1111/j.1365-2788.2001.00290.x

10.1046/j.1365-2788.1997.03838.x

Sparrow S. S., 1984, Vineland Adaptive Behavior Scales: Interview edition, Survey Form

Strauss D., 1996, Mortality of people with mental retardation in California with and without Down syndrome, 1986–1991, American Journal on Mental Retardation, 100, 643

10.1016/S0022-3476(97)70098-2

World Health Organization, 1977, Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: 9th Revision

World Health Organization, 1992, The International Statistical Classification of Diseases and Related Health Problems: 10th Revision

Yip P. S., 1995, Capture‐recapture and multiple‐record systems estimation: history and theoretical development, American Journal of Epidemiology, 142, 1047

10.3109/08880019209018329

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Journal of Intellectual Disability Research

Tập 51 Số 7

520-527

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