Management and prevalence of long‐term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population‐based cohort study

Cooper, Sally‐Ann; Hughes-McCormack, Laura Anne; Greenlaw, Nicola; McConnachie, Alex; Allan, Linda; Baltzer, M.; McArthur, Laura; Henderson, Angela; Melville, Craig; McSkimming, Paula; Morrison, Jill

doi:10.1111/jar.12386

Cited by 74 publications

(78 citation statements)

References 46 publications

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“…Societal, community and educational approaches impact on this, and are complex. Other relatively simple approaches have been shown to bring health benefits for adults with intellectual disabilities such as annual health checks conducted in primary care23 24 (not currently funded in Scotland), with mechanisms likely to relate to the poor access to healthcare and services that are typically reported for people with intellectual disabilities 25. It is important that future research focuses on further identification of solutions to the health inequalities we have evidenced.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and general health status of people with intellectual disabilities in Scotland: a total population study

Hughes-McCormack

Rydzewska

Henderson

et al. 2017

J Epidemiol Community Health

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Section: Discussionmentioning

confidence: 99%

Prevalence and general health status of people with intellectual disabilities in Scotland: a total population study

Hughes-McCormack

Rydzewska

Henderson

et al. 2017

J Epidemiol Community Health

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“…People with intellectual disabilities experience poor health in general, often with multimorbidity and complex additional care needs (Cooper et al . ; Hughes‐McCormack et al . ; Kinnear et al .…”

Section: Introductionmentioning

confidence: 99%

Oral health of adults with intellectual disabilities: a systematic review

Ward

Cooper

Hughes-McCormack

et al. 2019

J intellect Disabil Res

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Background There have been several past reports that adults with intellectual disabilities experience poor oral health (tooth loss, periodontal health and untreated dental caries). Loss of a functional dentition has serious consequences, including problems with chewing, swallowing, nutrition, speech, temporomandibular joint osteoarthritis and pain and systemic health conditions. Poor oral health is largely preventable through proactive oral care support. In recent years, social care provision for adults has changed, with deinstitutionalisation and home‐based personalised care now being the typical provision in high income countries. Hence, oral health inequalities might be reducing. However, there is limited recent evidence‐synthesis on the topic. We aimed to address this. Method PROSPERO registration number: CRD42018089880. We conducted a preferred reporting items for systematic reviews and meta‐analyses systematic review of publications since 2008. Four databases were searched with a clear search strategy, strict inclusion criteria for selection of papers, double scoring (two raters), systematic data extraction and quality appraisal of included papers. Results A total of 33/3958 retrieved articles were included, of which 14 were drawn from dental service users and 10 from Special Olympic athletes, therefore not necessarily being representative of the wider population with intellectual disabilities. Despite this limitation, adults with intellectual disabilities were still shown to experience poor oral health. High levels of poor oral hygiene and gingivitis were found, with many also affected by periodontitis and untreated dental decay. There is clear unmet need relating to both periodontal (gum) and tooth health, leading to tooth loss. Conclusions Despite reports in the past of poor oral health amongst adults with intellectual disabilities, and despite it being preventable, there remains a high burden of poor oral health. This highlights the need to raise awareness, and for polices on effective daily oral care, and appropriate service provision. The importance of oral health and its possible negative sequelae needs to be elevated amongst carers and professionals.

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“…As the life expectancy of people with intellectual disabilities (ID) increases (World Health Organisation 2000;Bittles et al 2002;Emerson et al 2012;Dieckmann et al 2015), they become more at risk of developing later non-communicable diseases, including type 2 diabetes mellitus (T2DM) (Hermans and Evenhuis 2014;Reppermund and Trollor 2016;Cooper et al 2018). In theory, prevention strategies should focus on reducing the burden of T2DM, but this can be challenging because of the complex interplay between physical and mental health problems, and support needs that contribute towards health inequalities in this population (Schutzwohl et al 2016;Kinnear et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors

Tyrer

Ling

Bhaumik

et al. 2020

J intellect Disabil Res

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Background As people with intellectual disabilities (ID) are now living longer, they are more at risk of developing non‐communicable diseases, including type 2 diabetes mellitus. However, understanding of factors associated with diabetes for targeted management and prevention strategies is limited. This study aimed to investigate prevalence of diabetes in adults (aged ≥18 years) with ID and its relationship with demographic, lifestyle, independence and health factors. Method This was a cross‐sectional analysis of interview data from 1091 adults with ID from the Leicestershire Learning Disability Register from 1 January 2010 to 31 December 2016. Logistic regression models were used to identify factors associated with diabetes in the study population. Results The study population did not have healthy lifestyles: just under half reported having lower physical activity levels than people without ID of a similar age; one‐quarter consumed fizzy drinks daily; and 20% consumed five or more fruit and/or vegetables per day. Prevalence of carer/self‐reported diabetes was 7.3% (95% confidence interval 5.9–9.0). After adjustment, diabetes was positively associated with South Asian ethnicity (P = 0.03) and older age groups (P < 0.001). Diabetes was less common in people living with family members (P = 0.02). We did not find a relationship between any of the lifestyle, independence and health factors investigated. Conclusions A significant proportion of people with ID are living with diabetes. Diabetes management and prevention strategies should be tailored to individuals' complex needs and include consideration of lifestyle choices. Such strategies may want to focus on adults of South Asian ethnicity and people living in residential homes where prevalence appears to be higher.

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Management and prevalence of long‐term conditions in primary health care for adults with intellectual disabilities compared with the general population: A population‐based cohort study

Abstract: Background: In the UK, general practitioners/family physicians receive pay for perfor-

Cited by 74 publications

References 46 publications

Prevalence and general health status of people with intellectual disabilities in Scotland: a total population study

Prevalence and general health status of people with intellectual disabilities in Scotland: a total population study

Oral health of adults with intellectual disabilities: a systematic review

Diabetes in adults with intellectual disability: prevalence and associated demographic, lifestyle, independence and health factors

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