Cardiovascular risk factors (diabetes, hypertension, hypercholesterolemia and metabolic syndrome) in older people with intellectual disability: results of the HA-ID study.
Half of older adults with ID already have diabetes or hypertension that no one has spotted—so screen, do not guess.
01Research in Context
What this study did
The Dutch HA-ID team asked 980 adults with intellectual disability aged 50-plus to a clinic.
They measured blood pressure, fasting sugar, and lipids to see how many had diabetes, hypertension, high cholesterol, or metabolic syndrome.
The goal was to compare rates with the general older population and to check past medical records for missed diagnoses.
What they found
Rates of diabetes, hypertension, and high cholesterol matched those of other Dutch seniors.
The shock: about half of the people with hypertension or diabetes had never been told they had it.
In other words, the risk is there, but it is silent until someone looks.
How this fits with other research
Hastings et al. (2002) saw the same quiet danger a decade earlier. Their survey of 1 371 adults with ID also flagged “lower reported” heart risks and suspected under-recognition.
Tassé et al. (2013) followed older Finnish clients for heart attacks and strokes and found no extra events versus the general public. Together the papers say: risk-factor levels are average, but detection is poor, so events could still climb.
Van Hanegem et al. (2014) proved the fix is simple. Free on-site screening in Singapore lifted regular check-ups from about 20 % to over 90 %. The HA-ID numbers show why that effort is needed.
Why it matters
If you support adults with ID, add blood-pressure, glucose, and cholesterol checks to every annual physical. Do not wait for symptoms; they may not be reported. A quick cuff, finger-stick, or lab slip can catch the half of cases that are still hidden and prevent later crises.
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02At a glance
03Original abstract
Hypertension, diabetes, hypercholesterolemia and the metabolic syndrome are important risk factors for cardiovascular disease (CVD). In older people with intellectual disability (ID), CVD is a substantial morbidity risk. The aims of the present study, which was part of the Healthy Ageing in Intellectual Disability (HA-ID) study, were (1) to determine the prevalence of CVD risk factors in older people with ID and to compare this with the prevalence in the same-aged general population, (2) to determine how many risk factors had not been previously diagnosed, and (3) to identify correlates of CVD risk factors (gender, age, level of ID, Down syndrome, independent living, activities of daily living, mobility, instrumental activities of daily living, physical activity, use of atypical antipsychotics, central obesity), using logistic regression analyses. In this cross-sectional study, 980 people with borderline to profound ID participated. Hypertension (53%), diabetes (14%) and metabolic syndrome (45%) were present similarly as in the general Dutch population. Hypercholesterolemia was present less often (23%). Fifty percent of the people with hypertension had not been previously diagnosed with this condition. Percentages for diabetes, hypercholesterolemia, and the metabolic syndrome were 45, 46 and 94 respectively. People who were more at risk for CVD risk factors were women, older people, people with obesity, people who lived more independently and people who were able to do groceries or prepare a meal independently. Policy on prevention, detection and treatment of CVD risk factors is urgently needed.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.04.010