Increased mortality in children and adolescents with developmental disabilities

Abstract

A population-based cohort of 10-year-old children with mental retardation, cerebral palsy, epilepsy, hearing impairment or vision impairment, who were ascertained at 10 years of age in a previous study conducted in metro Atlanta during 1985-87, was followed up for mortality and cause of death information. We used the National Death Index to identify all deaths among cohort members during the follow-up period (1985-95). We estimated expected numbers of deaths on the basis of actual age-, race- and sex-specific death rates for the entire Georgia population for 1989-91. The objective was to quantify the magnitude of increased mortality and evaluate the contribution of specific disabilities to mortality among children and adolescents with one or more of five developmental disabilities. A total of 30 deaths were observed; 10.1 deaths were expected, yielding an observed-to-expected mortality ratio of almost three to one. The numbers of observed deaths exceeded those of expected deaths, regardless of the number of disabilities present, but the ratios were statistically significant (at the 95% confidence level) only in children with three or more co-existing disabilities. In general, the magnitude of the mortality ratios was directly related to various measures of the severity of the person's disability. An exception to this pattern was the elevated mortality from cardiovascular disease among cohort members with isolated mental retardation (three observed deaths vs. 0.2 expected). The specific underlying causes of death among other deceased cohort members included some that were the putative cause of the developmental disability (e.g. a genetic syndrome) and others that could be considered intercurrent diseases or secondary health conditions (e.g. asthma). Prevention efforts to decrease mortality in adolescents and young adults with developmental disabilities may need to address serious conditions that are secondary to the underlying disability (i.e. infections, asthma, seizures) rather than towards injuries, accidents and poisonings, the primary causes of death for persons in this age group in the general population.

Developmental Disabilities and Socioeconomic Outcomes in Young Adulthood

“…Both respondents with physical and cognitive disabilities had lower education levels when compared with individuals without disabilities, consistent with findings from previous studies showing that individuals with any type of disability were less likely than their non-disabled peers to achieve age-appropriate education. 15,17,30 However, the association was more pronounced for cognitive disability (p,0.001). Respondents with a cognitive disability were less likely to be in professional/managerial occupations, had lower mean incomes, and had lower wage rates than those without a disability.…”

“…6,17,30,31 Age at Wave IV was measured in years and computed at the time of the interview. All other covariates were measured at Wave I.…”

Adolescent inpatient psychiatric admission rates and subsequent one‐year mortality in England: 1998–2004

“…Generally, the death rate for developmental disorders is reported to be raised by three times in 10-year-olds (Decouflé & Autry, 2002). The deaths are secondary to underlying disability, e.g., infections, asthma and seizures, rather than injuries, accidents and poisonings which are the more common causes of death for people in this age group in the general population.…”

Predictive Factors of Early Mortality in Children With Developmental Disabilities: A Case-Comparison Analysis

“…Chronic neurological disorders such as epilepsy were also found to be associated with early death in children with intellectual disability. 3,20 The increased survival associated with prematurity in children with cerebral palsy has been previously reported 8,23,24 and attributed to the better mobility among these children. 23 It is also conceivable that the different underlying mechanism and the consequent type of brain damage in premature compared with full-term infants is associated with a more extensive neurophysiological disturbance in the latter resulting in early death.…”