Background Obesity is a major public health concern internationally and this study aimed to measure the prevalence of obesity in adults with intellectual disabilities in comparison with general population data, and examine the factors associated with obesity. Methods This was a cross-sectional study of all adults with intellectual disabilities, in a defined geographical area, in the context of a primary care health screening programme. A total of 945 adults with intellectual disabilities were involved, all of whom were living in the community. Body mass index (BMI), demographic characteristics, socio-economic deprivation, level of intellectual disabilities and various health parameters were measured. Results Overall, 39.3% of women and 27.8% of men were obese, compared with 25.1% of women and 22.7% of men in the comparison general population. The mean BMI of women with intellectual disabilities (28.8, range 12.3-59, SD 7.8) was significantly greater than the mean BMI of men with intellectual disabilities (26.7, range 12.6-49, SD 5.9), and women were more likely to be obese than men with intellectual disabilities (v 2 = 29.6, P < 0.001). Regression analyses showed that for both women and men, the risk of overweight and obesity reduced as the severity of intellectual disabilities increased, and Down syndrome was associated with an increased risk of overweight and obesity. Conclusions There is a need to carry out research to further our understanding of the reasons behind the increased prevalence of obesity in adults with intellectual disabilities. Effective weight management interventions and accessible clinical services are required to reduce the health inequalities experienced by adults with intellectual disabilities.
Background Lack of regular physical activity is globally one of the most significant risks to health. The main aims of this study were to describe the types and levels of regular physical activity undertaken by adults with intellectual disabilities, and to investigate the factors predicting low activity. Materials and Methods Interviews were conducted with a community-based sample of adults with intellectual disabilities (n = 433) at two time points. Data hypothesized to be predictive of low levels of activity were collected at time 1. Descriptive data were collected on the frequency and intensity, and actual level of participation in activities at time 2. Results Only 150 (34.6%) adults with intellectual disabilities undertook any regular activity of at least moderate intensity. This was of shorter duration, compared with the general population. Older age, having immobility, epilepsy, no daytime opportunities, living in congregate care and faecal incontinence were independently predictive of low levels of activity.Conclusions These results are a step towards informing the development of interventions to promote the health of adults with intellectual disabilities through increased physical activity.
Background Carers can have a significant impact supporting people with intellectual disabilities to make healthy lifestyle choices. This study examines carers' training needs on diet and physical activity. Methods A cross-sectional survey was undertaken of the knowledge and perceptions of carers supporting adults with intellectual disabilities. An interviewer administered questionnaire was used to examine carer knowledge of public health recommendations on diet and physical activity; perceptions of the benefits of healthy diets and physical activity levels; and the carer views on the barriers to change experienced by individuals with intellectual disabilities. Results Sixty-three carers took part in the study. They generally had a low level of knowledge around public health recommendations on diet and physical activity. Greater importance was attributed to the health benefits of diet than physical activity. Carers rated intrapersonal barriers to change within the person with intellectual disabilities as more important, than interpersonal or external barriers to change, with significant differences in perceived barriers relevant to diet and physical activity. Conclusions Carers supporting adults with intellectual disabilities have significant training needs relevant to promoting healthy lifestyles. This highlights the opportunity to promote health improvement via the development, and provision, of effective training initiatives.
Anxiety is a common problem in children and adolescents with autism spectrum disorder (ASD). This meta-analysis aimed to systematically evaluate the evidence for the use of psychosocial interventions to manage anxiety in this population. Cognitive behavioural therapy (CBT) was the primary intervention modality studied. A comprehensive systematic search and study selection process was conducted. Separate statistical analyses were carried out for clinician-, parent-, and self-reported outcome measures. Sensitivity analyses were conducted by removing any outlying studies and any studies that did not use a CBT intervention. A subgroup analysis was performed to compare individual and group delivery of treatment. Ten randomised control trials involving a total of 470 participants were included. The overall SMD was d = 1.05 (95 % CI 0.45, 1.65; z = 3.45, p = 0.0006) for clinician- reported outcome measures; d = 1.00 (95%CI 0.21, 1.80; z = 2.47, p = 0.01) for parent-reported outcome measures; and d = 0.65 (95%CI -0.10, 1.07; z = 1.63, p = 0.10) for self-reported outcome measures. Clinician- and parent-reported outcome measures showed that psychosocial interventions were superior to waitlist and treatment-as-usual control conditions at post-treatment. However, the results of self-reported outcome measures failed to reach significance. The sensitivity analyses did not significantly change these results and the subgroup analysis indicated that individual treatment was more effective than group treatment. The main limitations of this review were the small number of included studies as well as the clinical and methodological variability between studies.
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