Multiple physical and mental health comorbidity in adults with intellectual disabilities

population-based cross-sectional analysis

Sally-Ann Cooper (Lead / Corresponding author), Gary McLean, Bruce Guthrie, Alex McConnachie, Stewart Mercer, Frank Sullivan, Jill Morrison

    Research output: Contribution to journalArticle

    67 Citations (Scopus)

    Abstract

    BACKGROUND: Adults with intellectual disabilities have increased early mortality compared with the general population. However, their extent of multimorbidity (two or more additional conditions) compared with the general population is unknown, particularly with regards to physical ill-health, as are associations between comorbidities, neighbourhood deprivation, and age.

    METHODS: We analysed primary health-care data on 1,424,378 adults registered with 314 representative Scottish practices. Data on intellectual disabilities, 32 physical, and six mental health conditions were extracted. We generated standardised prevalence rates by age-groups, gender, and neighbourhood deprivation, then calculated odds ratio (OR) and 95 % confidence intervals (95 % CI) for adults with intellectual disabilities compared to those without, for the prevalence, and number of condition.

    RESULTS: Eight thousand fourteen (0.56 %) had intellectual disabilities, of whom only 31.8 % had no other conditions compared to 51.6 % without intellectual disabilities (OR 0.26, 95 % 0.25-0.27). The intellectual disabilities group were significantly more likely to have more conditions, with the biggest difference found for three conditions (10.9 % versus 6.8 %; OR 2.28, 95 % CI 2.10-2.46). Fourteen physical conditions were significantly more prevalent, and four cardiovascular conditions occurred less frequently, as did any cancers, and chronic obstructive pulmonary diseases. Five of the six mental health conditions were significantly more prevalent. For the adults with intellectual disabilities, no gradient was seen in extent of multimorbidity with increasing neighbourhood deprivation; indeed findings were similar in the most affluent and most deprived areas. Co-morbidity increased with age but is highly prevalent at all ages, being similar at age 20-25 to 50-54 year olds in the general population.

    CONCLUSIONS: Multi-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs, for adults with intellectual disabilities compared with the general population. There is no association with neighbourhood deprivation; people with intellectual disabilities need focussed services irrespective of where they live, and at a much earlier age than the general population. They require specific initiatives to reduce inequalities.

    Original languageEnglish
    Article number110
    Number of pages11
    JournalBMC Family Practice
    Volume16
    DOIs
    Publication statusPublished - 27 Aug 2015

    Fingerprint

    Intellectual Disability
    Comorbidity
    Mental Health
    Cross-Sectional Studies
    Population
    Odds Ratio
    Confidence Intervals
    Morbidity
    Health
    Disabled Persons
    Chronic Obstructive Pulmonary Disease
    Primary Health Care
    Age Groups
    Mortality

    Cite this

    Cooper, Sally-Ann ; McLean, Gary ; Guthrie, Bruce ; McConnachie, Alex ; Mercer, Stewart ; Sullivan, Frank ; Morrison, Jill. / Multiple physical and mental health comorbidity in adults with intellectual disabilities : population-based cross-sectional analysis. In: BMC Family Practice. 2015 ; Vol. 16.
    @article{09f1b59a8a614c2fb5ffb93967235cab,
    title = "Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis",
    abstract = "BACKGROUND: Adults with intellectual disabilities have increased early mortality compared with the general population. However, their extent of multimorbidity (two or more additional conditions) compared with the general population is unknown, particularly with regards to physical ill-health, as are associations between comorbidities, neighbourhood deprivation, and age.METHODS: We analysed primary health-care data on 1,424,378 adults registered with 314 representative Scottish practices. Data on intellectual disabilities, 32 physical, and six mental health conditions were extracted. We generated standardised prevalence rates by age-groups, gender, and neighbourhood deprivation, then calculated odds ratio (OR) and 95 {\%} confidence intervals (95 {\%} CI) for adults with intellectual disabilities compared to those without, for the prevalence, and number of condition.RESULTS: Eight thousand fourteen (0.56 {\%}) had intellectual disabilities, of whom only 31.8 {\%} had no other conditions compared to 51.6 {\%} without intellectual disabilities (OR 0.26, 95 {\%} 0.25-0.27). The intellectual disabilities group were significantly more likely to have more conditions, with the biggest difference found for three conditions (10.9 {\%} versus 6.8 {\%}; OR 2.28, 95 {\%} CI 2.10-2.46). Fourteen physical conditions were significantly more prevalent, and four cardiovascular conditions occurred less frequently, as did any cancers, and chronic obstructive pulmonary diseases. Five of the six mental health conditions were significantly more prevalent. For the adults with intellectual disabilities, no gradient was seen in extent of multimorbidity with increasing neighbourhood deprivation; indeed findings were similar in the most affluent and most deprived areas. Co-morbidity increased with age but is highly prevalent at all ages, being similar at age 20-25 to 50-54 year olds in the general population.CONCLUSIONS: Multi-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs, for adults with intellectual disabilities compared with the general population. There is no association with neighbourhood deprivation; people with intellectual disabilities need focussed services irrespective of where they live, and at a much earlier age than the general population. They require specific initiatives to reduce inequalities.",
    author = "Sally-Ann Cooper and Gary McLean and Bruce Guthrie and Alex McConnachie and Stewart Mercer and Frank Sullivan and Jill Morrison",
    year = "2015",
    month = "8",
    day = "27",
    doi = "10.1186/s12875-015-0329-3",
    language = "English",
    volume = "16",
    journal = "BMC Family Practice",
    issn = "1471-2296",
    publisher = "Springer Verlag",

    }

    Multiple physical and mental health comorbidity in adults with intellectual disabilities : population-based cross-sectional analysis. / Cooper, Sally-Ann (Lead / Corresponding author); McLean, Gary; Guthrie, Bruce; McConnachie, Alex; Mercer, Stewart; Sullivan, Frank; Morrison, Jill.

    In: BMC Family Practice, Vol. 16, 110, 27.08.2015.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Multiple physical and mental health comorbidity in adults with intellectual disabilities

    T2 - population-based cross-sectional analysis

    AU - Cooper, Sally-Ann

    AU - McLean, Gary

    AU - Guthrie, Bruce

    AU - McConnachie, Alex

    AU - Mercer, Stewart

    AU - Sullivan, Frank

    AU - Morrison, Jill

    PY - 2015/8/27

    Y1 - 2015/8/27

    N2 - BACKGROUND: Adults with intellectual disabilities have increased early mortality compared with the general population. However, their extent of multimorbidity (two or more additional conditions) compared with the general population is unknown, particularly with regards to physical ill-health, as are associations between comorbidities, neighbourhood deprivation, and age.METHODS: We analysed primary health-care data on 1,424,378 adults registered with 314 representative Scottish practices. Data on intellectual disabilities, 32 physical, and six mental health conditions were extracted. We generated standardised prevalence rates by age-groups, gender, and neighbourhood deprivation, then calculated odds ratio (OR) and 95 % confidence intervals (95 % CI) for adults with intellectual disabilities compared to those without, for the prevalence, and number of condition.RESULTS: Eight thousand fourteen (0.56 %) had intellectual disabilities, of whom only 31.8 % had no other conditions compared to 51.6 % without intellectual disabilities (OR 0.26, 95 % 0.25-0.27). The intellectual disabilities group were significantly more likely to have more conditions, with the biggest difference found for three conditions (10.9 % versus 6.8 %; OR 2.28, 95 % CI 2.10-2.46). Fourteen physical conditions were significantly more prevalent, and four cardiovascular conditions occurred less frequently, as did any cancers, and chronic obstructive pulmonary diseases. Five of the six mental health conditions were significantly more prevalent. For the adults with intellectual disabilities, no gradient was seen in extent of multimorbidity with increasing neighbourhood deprivation; indeed findings were similar in the most affluent and most deprived areas. Co-morbidity increased with age but is highly prevalent at all ages, being similar at age 20-25 to 50-54 year olds in the general population.CONCLUSIONS: Multi-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs, for adults with intellectual disabilities compared with the general population. There is no association with neighbourhood deprivation; people with intellectual disabilities need focussed services irrespective of where they live, and at a much earlier age than the general population. They require specific initiatives to reduce inequalities.

    AB - BACKGROUND: Adults with intellectual disabilities have increased early mortality compared with the general population. However, their extent of multimorbidity (two or more additional conditions) compared with the general population is unknown, particularly with regards to physical ill-health, as are associations between comorbidities, neighbourhood deprivation, and age.METHODS: We analysed primary health-care data on 1,424,378 adults registered with 314 representative Scottish practices. Data on intellectual disabilities, 32 physical, and six mental health conditions were extracted. We generated standardised prevalence rates by age-groups, gender, and neighbourhood deprivation, then calculated odds ratio (OR) and 95 % confidence intervals (95 % CI) for adults with intellectual disabilities compared to those without, for the prevalence, and number of condition.RESULTS: Eight thousand fourteen (0.56 %) had intellectual disabilities, of whom only 31.8 % had no other conditions compared to 51.6 % without intellectual disabilities (OR 0.26, 95 % 0.25-0.27). The intellectual disabilities group were significantly more likely to have more conditions, with the biggest difference found for three conditions (10.9 % versus 6.8 %; OR 2.28, 95 % CI 2.10-2.46). Fourteen physical conditions were significantly more prevalent, and four cardiovascular conditions occurred less frequently, as did any cancers, and chronic obstructive pulmonary diseases. Five of the six mental health conditions were significantly more prevalent. For the adults with intellectual disabilities, no gradient was seen in extent of multimorbidity with increasing neighbourhood deprivation; indeed findings were similar in the most affluent and most deprived areas. Co-morbidity increased with age but is highly prevalent at all ages, being similar at age 20-25 to 50-54 year olds in the general population.CONCLUSIONS: Multi-morbidity burden is greater, occurs at much earlier age, and the profile of health conditions differs, for adults with intellectual disabilities compared with the general population. There is no association with neighbourhood deprivation; people with intellectual disabilities need focussed services irrespective of where they live, and at a much earlier age than the general population. They require specific initiatives to reduce inequalities.

    U2 - 10.1186/s12875-015-0329-3

    DO - 10.1186/s12875-015-0329-3

    M3 - Article

    VL - 16

    JO - BMC Family Practice

    JF - BMC Family Practice

    SN - 1471-2296

    M1 - 110

    ER -