Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

Abstract

Background Multimorbidity [two or more conditions in addition to intellectual disability (ID)] is known to be more common among people with ID. However, the relationship between multimorbidity and lifestyle factors is currently unknown. The aim of this study was to determine the prevalence of multimorbidity in a population of adults with ID. We also aimed to identify risk factors, including lifestyle factors, for multimorbidity in this population. Methods This was a cross‐sectional analysis using data from a diabetes screening study of 920 adults aged 18–74 years with ID living in Leicestershire, UK. We described comorbidities and the prevalence of multimorbidity in this population. We explored the relationship between multimorbidity and age, gender, ethnicity, severity of ID, socio‐economic status, physical activity, sedentary behaviour, fruit and vegetable consumption and smoking status using multiple logistic regression. Results The prevalence of multimorbidity was 61.2% (95% CI 57.7–64.7). Multimorbidity was independently associated with being female (P < 0.001) and severe/profound ID (P = 0.004). Increasing age was of borderline significance (P = 0.06). Individuals who were physically inactive or sedentary were more likely to be multimorbid, independent of ability to walk, age, gender, severity of ID, ethnicity and socio‐economic status (adjusted OR = 1.91; 95% CI 1.23–2.97; P = 0.004 and OR = 1.98; 95% CI 1.42–2.77; P < 0.001). After excluding probable life‐long conditions (autism spectrum conditions, attention deficit hyperactivity disorders, epilepsy, cerebral palsy and other paralytic syndromes) as contributing comorbidities, the effect of sedentary behaviour, but not physical activity, remained (P = 0.004). We did not observe a relationship between multimorbidity, fruit and vegetable consumption and smoking status. Conclusions Multimorbidity presents a significant burden to people with ID. Individuals who were physically inactive or sedentary were more likely to be multimorbid, but further work is recommended to explore the relationship between multimorbidity and lifestyle factors using standardised objective measures.

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

“…; Tyrer et al . ), differ by accommodation status. Prior research suggests a selection mechanism whereby healthy adults (as opposed to less healthy) adults with ID are less likely to be moved from family homes to residential accommodation (Woodman et al .…”

“…Residential carers may also encounter organisational barriers to enforcing healthy lifestyle behaviours (O'Leary et al 2018). However, it is equally possible that individual-level factors associated with lifestyle, such as knowledge about diabetes, severity of ID and multimorbidity (Caton et al 2012;Melville et al 2018;Tyrer et al 2019), differ by accommodation status. Prior research suggests a selection mechanism whereby healthy adults (as opposed to less healthy) adults with ID are less likely to be moved from family homes to residential accommodation (Woodman et al 2014) which would suggest that people with diabetes are more likely to transfer to residential settings.…”

“…Compared with the general population, people with ID are more likely to have unhealthier diets (Robertson et al 2000;Hoey et al 2017), exercise less (Bartlo and Klein 2011;Dairo et al 2016) and lead more sedentary lifestyles (Haveman et al 2011;Melville et al 2018). They are also more likely to have complex physical health and/or mental health problems (Cooper et al 2015;Hughes-McCormack et al 2017) which further decreases their likelihood of leading healthy lifestyles Tyrer et al 2019).…”

Metabolic syndrome and its components in people with intellectual disability: a meta‐analysis

“…There were also insufficient data to explore physical inactivity and unhealthy eating as moderating factors. There is abundance of evidence that people with intellectual disability are physically inactive (Kim and Yi, 2018; Diaz, 2020), sedentary (Tyrer et al ., 2019) and have unhealthy eating habits (Draheim et al ., 2002; McGuire et al ., 2007). Thus, considering the metabolic risks observed in our study and the behavioural risk factors observed in people with intellectual disability, our findings support previous calls for evidence‐based integrated models of care for this patient group including screening for and trying to minimise cardio‐metabolic risk factors (Sivakumar, 2007; Baburaj and El Tahir, 2011; Teeluckdharry et al ., 2013).…”

“…Respiratory and cardiovascular diseases are the main causes of premature death (O'Leary et al ., 2018). Risk factors predisposing people with intellectual disability to an increased risk for cardiovascular diseases include an impaired cardiorespiratory fitness (Oppewal and Hilgenkamp, 2020) and associated unhealthy lifestyle behaviours such as lack of sufficient physical activity (Kim and Yi, 2018; Diaz, 2020), sedentary behaviour (Tyrer et al ., 2019) and an unhealthy diet (Draheim et al ., 2002; McGuire et al ., 2007). People with mild to moderate intellectual disability are at the highest risk for physical inactivity, sedentary behaviour and unhealthy eating patterns (Emerson, 2005), while data on smoking are mixed with some studies reporting less smoking (Taylor et al ., 2004), and other more (Emerson, 2011).…”