Asthma, smoking and BMI in adults with intellectual disabilities: a community‐based survey

Gale, Lauren; Naqvi, Haider; Russ, Lesley

doi:10.1111/j.1365-2788.2009.01192.x

Cited by 37 publications

(31 citation statements)

References 44 publications

(86 reference statements)

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“…While some researchers report that the prevalence of overweight status is higher in women than men (Bhaumik et al, 2008;Gale, Naqvi, & Russ, 2009;Mikulovic et al, 2014), others have found it to be higher in men (Hsieh et al, 2014), and others (Li, Frey, McCormick, & Johnston, 2015;McGuire, Daly, & Smyth, 2007) found no gender differences regarding BMI.…”

Section: Gendermentioning

confidence: 98%

Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders

Ranjan

Nasser

Fisher

2017

Research Intellect Disabil

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Background:The prevalence of being overweight and obese is increasing not just in the general population but also in individuals with intellectual disability (ID). Therefore, a need to identify factors contributing to overweight/obesity arises as this population is escalating. Materials and Methods:This narrative review article summarizes pertinent research focusing on prevalence and the potential factors associated with overweight and obesity in adults with intellectual disability during the past decade.Results: Prevalence of being overweight and obese among adults with intellectual disability is reportedly 28%-71% and 17%-43%, respectively. Factors increasing the susceptibility of being overweight or obese have been identified as female gender, increasing age, having a certain diagnosis, mild intellectual disability, as well as living independently/with family, consuming certain prescription medications, and non-participation in physical activities. Conclusion:Identification of the potential risk factors associated with being overweight and obese in this population will help tackle the challenges faced by this growing adult population with intellectual disability. K E Y W O R D Sintellectual disability, obesity, overweight, potential factors, prevalence | INTRODUCTIONDuring the past decades, life expectancy of the people with intellectual disabilities (IDs) has increased considerably and follows similar increasing trends to those found in the general population except for those with Down syndrome or epilepsy and or severe and multiple disabilities (Coppus, 2013;Hosking et al., 2016;Patja, Iivanainen, Vesala, Oksanen, & Ruoppila, 2000). Data from the United Kingdom, however, report significantly higher mortality among individuals with intellectual disability compared to the general population; the median age at death of male and female individuals with intellectual disability being 65 and 63 years, respectively compared to 78 and 83 years in the general population (Heslop et al., 2014;Hosking et al., 2016).Most common causes of death among individuals with intellectual disability are reportedly cardiovascular diseases, respiratory diseases and neoplasms (Janicki et al., 2002;Patja, Molsa, & Iivanainen, 2001).In their large 35-year follow-up research, Patja et al. (2001) showed that the disease mortality pattern was high up to 40 years of age, but did not increase after that indicating that older people with intellectual disability had a similar mortality pattern to the general population.Health care professionals are therefore posed with new challenges, as lack of good-quality health care is reportedly an important contributory factor to mortality among this population (Heslop et al., 2014;Hosking et al., 2016).With more than one-third of adults (36.9% men & 38.0% women) in the world being overweight or obese (Ng et al., 2014), it is logical to believe that there is a rise or similar increasing trend in the prevalence of being overweight and obese in adults with intellectual disability. Data on US population...

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Section: Gendermentioning

confidence: 98%

Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders

Ranjan

Nasser

Fisher

2017

Research Intellect Disabil

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“…This study observed also combined effects of smoking and obesity; a very high risk of death was found in obese heavy smokers. Also, another study observed that a very high proportion of people with intellectual disabilities and asthma were also current smokers and/or obese [6], confirming that both smoking and obesity are involved in the development of asthma and associated with worse disease outcomes.…”

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confidence: 97%

“…Furthermore, the findings underline the importance of long-running birth cohorts enabling studies where recall bias is limited. As recent retrospective reports suggest that adult chronic obstructive pulmonary disease may have an early-life origin [5,6], the need for long-term prospective cohorts to address this specific question is obvious.With the additional data now presented by R.J. Kurukulaaratchy and co-workers on the natural course of early life wheeze, we suggest a reconsideration of the possibility of diagnosing asthma in preschool children as well as caution when addressing the potential favourable long-term prognosis of early recurrent wheezy illness. Can overweight/obesity and smoking have combined effects on bronchial hyperresponsiveness?…”

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confidence: 99%

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Can overweight/obesity and smoking have combined effects on bronchial hyperresponsiveness?

Sposato¹,

Scalese

2014

European Respiratory Journal

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We wish to thank R.J. Kurukulaaratchy and co-workers for their positive response to our article [1]. We were happy to see that our paper encouraged the Isle of Wight Birth Cohort (IOWBC) to assess the prognosis of early recurrent wheeze into the beginning adulthood. As the corresponding findings in the IOWBC, with its high 18-year follow-up rate of 90% [2], are in line with those from our Environment and Childhood Asthma Study, it strengthens the message that the longer term prognosis of early recurrent wheeze might not be as favourable as previously conceived [3,4]. Furthermore, the findings underline the importance of long-running birth cohorts enabling studies where recall bias is limited. As recent retrospective reports suggest that adult chronic obstructive pulmonary disease may have an early-life origin [5,6], the need for long-term prospective cohorts to address this specific question is obvious.With the additional data now presented by R.J. Kurukulaaratchy and co-workers on the natural course of early life wheeze, we suggest a reconsideration of the possibility of diagnosing asthma in preschool children as well as caution when addressing the potential favourable long-term prognosis of early recurrent wheezy illness. Can overweight/obesity and smoking have combined effects on bronchial hyperresponsiveness?To the Editor:We read with interest the article by JUUSELA et al.[1], which showed a significant risk factor for bronchial hyperresponsiveness (BHR) with a dose-dependent pattern and which underlined that BHR severity increases with increased smoking (pack-years) in an adult sample of the general population. Unfortunately, in their study the authors did not analyse a possible additional influence of overweight/obese status on BHR. In fact, several researchers have shown that the overweight/obese condition may be a risk factor for BHR (adjusted for smoking), both in healthy subjects and, in particular, in asthmatics [2][3][4]. A fair amount Eur Respir J 2014; 43: 651 |

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“…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%

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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Asthma, smoking and BMI in adults with intellectual disabilities: a community‐based survey

Cited by 37 publications

References 44 publications

Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders

Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders

Can overweight/obesity and smoking have combined effects on bronchial hyperresponsiveness?

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

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