The impact of living arrangements and deinstitutionalisation in the health status of persons with intellectual disability in Europe

Abstract

Background Despite progress in the process of deinstitutionalisation, very little is known about the health conditions of people with intellectual disability (PWID) who live in large institutions and PWID living in small residential services, family homes or independent living within the community. Furthermore, there are no international comparison studies at European level of the health status and health risk factors of PWID living in fully staffed residential services with formal support and care compared with those living in unstaffed family homes or independent houses with no formal support. Methods A total of 1269 persons with ID and/or their proxy respondents were recruited and face-to-face interviewed in 14 EU countries with the P15, a multinational assessment battery for collecting data on health indicators relevant to PWID. Participants were grouped according to their living arrangements, availability of formal support and stage of deinstitutionalisation. Results Obesity and sedentary lifestyle along with a number of illnesses such as epilepsy, mental disorders, allergies or constipation were highly prevalent among PWID. A significantly higher presence of myocardial infarctions, chronic bronchitis, osteoporosis and gastric or duodenal ulcers was found among participants in countries considered to be at the early stage of deinstitutionalisation. Regardless of deinstitutionalisation stage, important deficits in variables related to such medical health promotion measures as vaccinations, cancer screenings and medical checks were found in family homes and independent living arrangements. Age, number of people living in the same home or number of places in residential services, presence of affective symptoms and obesity require further attention as they seem to be related to an increase in the number of illnesses suffered by PWID. Discussion Particular illnesses were found to be highly prevalent in PWID. There were important differences between different living arrangements depending on the level of formal support available and the stage of deinstitutionalisation. PWID are in need of tailored primary health programs that guarantee their access to quality health and health promotion and the preventative health actions of vaccination programs, systematic health checks, specific screenings and nutritional controls. Extensive national health surveys and epidemiological studies of PWID in the EC member states are urgently needed in order to reduce increased morbidity rates among this population.

Health profiles in people with intellectual developmental disorders

“…Previous research, findings are consistent with the results presented here: residence patients are significantly older than those living in community settings, 26,28,29 are affected by more severe levels of IDD 28 and are more likely to suffer from mental health problems and behavioral disorders. 28,29 In this sense, recent literature shows that people with IDD have a higher risk of developing comorbid psychopathology, and their symptoms remain relatively stable over time.…”

“…26,27 Similarly, subjects with more severe levels of IDD often dwell at residence institutions and have a higher risk of diseases like epilepsy, mobility issues, mental health problems and behaviour disorders. 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.…”

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

“…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.…”

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

“…Este mismo estudio concluye que se necesitan al menos 134 psiquiatras y psicólogos especializados y 277 camas en servicios especializados para cumplir con los estándares de atención necesarios. 53 Una de las limitaciones más importantes para la correcta atención de las personas con TDI es la falta de formación al respecto de los profesionales sanitarios. En el ámbito europeo, los contenidos relacionados con el TDI en los programas formativos de los profesionales sanitarios son mínimos; las publicaciones sobre la formación y el entrenamiento de profesionales son igualmente escasas.…”