Cause of death in adults with intellectual disability in the United States.
Choking and chest infections are the fast killers of adults with ID—guard the airway every day.
01Research in Context
What this study did
Garwood et al. (2021) looked at US death certificates for adults with intellectual disability. They compared causes of death to the general adult population.
What they found
Heart disease still tops the list, but adults with ID die from choking and lung infections far more often. Mild and moderate ID also raises diabetes death risk.
How this fits with other research
Perez et al. (2015) saw the same pattern in the UK: respiratory infection, not poor nutrition, was the main killer in adults who needed mealtime help. The match shows the danger is real across countries.
Nijs et al. (2016) seems to disagree: in Norway injuries, not infections, sent most adults with ID to the hospital. The gap is about data source—Norway counted admissions for any reason, while the US study counted final causes of death. Both can be true: injuries get you admitted, but lung infections and choking finish the job.
Sandberg et al. (2026) widens the lens. Their coming registry data will map diagnosis rates across body systems, placing the US death findings inside a fuller health timeline.
Why it matters
Add swallow screens and aspiration precautions to every adult support plan. Watch for cough, fever, or wet voice after meals. These simple checks cut the extra risk the numbers keep showing.
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02At a glance
03Original abstract
BACKGROUND: Prior studies report that adults with intellectual disability (ID) have cause of death patterns distinct from adults in the general population but do not provide comparative analysis by specific causes of death. METHODS: Data are from the National Vital Statistics System 2005-2017 US Multiple Cause-of-Death Mortality files. We utilised adjusted odds ratios to identify causes of death that were more common for adults whose death certificate indicated ID (N = 22 512) than for adults whose death certificate did not indicate ID (N = 32 738 229), controlling for severity level of ID. We then examine the associations between biological sex and race-ethnicity and causes of death solely among adults with ID. RESULTS: The leading cause of death for adults with and without ID indicated on their death certificate was heart disease. Adults with ID, regardless of the severity of the disability, had substantially higher risk of death from pneumonitis, influenza/pneumonia and choking. Adults with mild/moderate ID also had higher risk of death from diabetes mellitus. Differences in cause of death trends were associated with biological sex and race-ethnicity. CONCLUSIONS: Efforts to reduce premature mortality for adults with ID should attend to risk factors for causes of death typical in the general population such as heart disease and cancer, but also should be cognisant of increased risk of death from choking among all adults with ID, and diabetes among adults with mild/moderate ID. Further research is needed to better understand the factors determining comparatively lower rates of death from neoplasms and demographic differences in causes of death among adults with ID.
Journal of intellectual disability research : JIDR, 2021 · doi:10.1111/jir.12790