Ageing and health status in adults with intellectual disabilities: Results of the European POMONA II study

Haveman, Meindert; Perry, Jonathan; Salvador‐Carulla, Luis; Walsh, Patricia Noonan; Kerr, Michael Patrick; Valk, Henny van Schrojenstein Lantman-de; Hove, Geert Van; Berger, Dasa Moravec; Azéma, Bernard; Buono, Serafino; Cara, Alexandra Carmen; Germanavičius, Arūnas; Linehan, Christine; Määttä, Tuomo; Tøssebro, Jan; Weber, Germain

doi:10.3109/13668250.2010.549464

Cited by 154 publications

(101 citation statements)

References 68 publications

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“…Four of these articles 90,[102][103][104] reported findings from the same study and a further two articles 109,125 reported findings from the same study, leaving 58 studies (see Table 3) remaining for the final systematic review and meta-analysis.…”

Section: Study Selectionmentioning

confidence: 99%

“…Primarily, the included studies were cross-sectional observational (n = 31 81,82,98,[100][101][102]104,106,[109][110][111]114,116,119,121,124,[126][127][128][129][130][131][132][133][134][135]137,139,142,143,145 ). The remaining studies involved retrospective database or medical records data (n = 22 [83][84][85][86][87][88][89]94,95,99,107,113,115,117,118,120,122,123,136,…”

Section: Study Characteristicsmentioning

confidence: 99%

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Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Dunkley

Tyrer

Spong

et al. 2017

Programme Grants Appl Res

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“…36 Muchos de los problemas de salud de las personas mayores con TDI permanecen sin identificar, no sólo por ellos mismos sino también por sus familiares, por el personal que los atiende y por los profesionales sanitarios. 37 Asimismo, la presentación clínica de la demencia en la persona con TDI puede diferir de la de la población general, ya que los cambios de personalidad y de comportamiento aparecen más temprano en el curso de la enfermedad. Por otra parte, es muy probable que haya un elevado número de demencias no diagnosticadas en esta población debido a las dificultades para establecer un diagnóstico y en el acceso a los servicios de atención de salud.…”

Section: Envejecimientounclassified

“…Por último, se encontraron evidencias de disparidades de salud en las personas mayores con TDI, particularmente en términos de infradiagnóstico y de falta de medidas de prevención en salud. 37 En España, el proyecto Pomona II recogió una muestra de 111 sujetos con TDI, y los datos obtenidos se compararon con los de la población general. La muestra con TDI presentó más casos de epilepsia, obesidad y dolor bucal, así como una elevada presencia de problemas sensoriales, de movilidad y psicosis.…”

Section: Proyecto Pomona IIunclassified

Nuevas consideraciones sobre la salud de las personas con trastornos del desarrollo intelectual

et al. 2017

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La literatura reciente indica que las personas con trastornos del desarrollo intelectual (TDI) presentan diferencias respecto de la población general en cuanto a la prevalencia de determinadas enfermedades y a la atención sanitaria que reciben. El conocimiento actual con base en la evidencia es aún muy escaso en países no anglosajones. Los proyectos europeos POMONA-I y POMONA-II tenían el objetivo de recoger información sobre el estado de salud de las personas con TDI en Europa. Actualmente, el proyecto POMONAESP en España pretende recoger dicha información en una muestra amplia y representativa de personas con TDI. También se están llevando a cabo otros estudios sobre la necesidad de contar con servicios especializados y sobre la formación que reciben los profesionales sanitarios sobre TDI. En este artículo se revisan las últimas evidencias sobre la salud de las personas con TDI y se exponen las principales actividades de investigación y asistencia sanitaria sobre este tema.

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“…28 Besides presenting more severe levels of IDD, mental health issues and behaviour disorders, the population living in institutions has a higher mean age than their peers living in family households, and often leads a more sedentary life. 26,29 All these studies reflect the influence of variables like the severity of the IDD, ageing and institutionalization on the health status. This paper analyses the data from the survey EDAD 2008 carried out in order to understand the relationship of these variables with health profiles of people with IDD living in Spain.…”

Section: Health In Intellectual Developmental Disordersmentioning

confidence: 99%

Health profiles in people with intellectual developmental disorders

et al. 2017

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Objective. To better understand the health profiles of people with intellectual disability (ID), focusing on the variables that are associated with a poorer health status. Materials and methods. Data were collected from the Survey on Disability, Personal Autonomy and Dependency (EDAD 2008) of the Spanish National Statistics Institute (INE). The health data of 2 840 subjects with IDD were analyzed in order to verify the impact of different variables on their health profiles. Results. People with severe and profound levels of IDD presented a higher number of medical diagnoses. At residence centers there was a larger proportion of individuals with a higher prevalence of chronic diseases and more severe conditions; age also was an important factor. Conclusion. The health profiles of individuals with IDD differ depending on the severity level of their IDD and their degree of institutionalization. Further research is needed to provide better health care for people with IDD.

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Ageing and health status in adults with intellectual disabilities: Results of the European POMONA II study

Abstract: Some evidence of health disparities was found for older people with ID, particularly in terms of underdiagnosed or inadequately managed preventable health conditions.

Cited by 154 publications

References 68 publications

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project

Nuevas consideraciones sobre la salud de las personas con trastornos del desarrollo intelectual

Health profiles in people with intellectual developmental disorders

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