Causes of Mortality in Older People With Intellectual Disability: Results From the HA-ID Study.
Pneumonia is the top killer in older adults with ID, especially Down syndrome—guard their lungs like gold.
01Research in Context
What this study did
Oppewal et al. (2018) tracked every death in a Dutch group of older adults with intellectual disability.
They listed the exact medical cause written on each death certificate.
The team also split the group by Down syndrome versus other ID diagnoses.
What they found
Pneumonia and other lung diseases topped the list for both immediate and main cause of death.
Adults with Down syndrome died from breathing problems even more often.
They also showed extra deaths linked to dementia.
How this fits with other research
Eggleston et al. (2018) used the same Dutch cohort and added a warning: having four or more chronic illnesses or taking five-plus medicines doubled the chance of dying within five years.
Pitchford et al. (2019) then showed that lung trouble also drives more hospital readmissions within 30 days, so the risk pathway is respiratory illness → repeat hospital stays → death.
Landes (2017) looked at U.S. data and saw the mortality gap between people with and without ID shrink with age; Alyt’s cause-of-death table helps explain why many never reach very old age.
Why it matters
If you serve adults with ID who are over 50, treat every cough or cold as high priority. Push for flu and pneumonia vaccines, chest physio, and quick MD visits. Track meds yearly—Eggleston et al. (2018) showed polypharmacy is a red flag. These steps can keep clients out of the hospital and alive longer.
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02At a glance
03Original abstract
We aim to provide insight into the cause-specific mortality of older adults with intellectual disability (ID), with and without Down syndrome (DS), and compare this to the general population. Immediate and primary cause of death were collected through medical files of 1,050 older adults with ID, 5 years after the start of the Healthy Ageing and Intellectual Disabilities (HA-ID) study. During the follow-up period, 207 (19.7%) participants died, of whom 54 (26.1%) had DS. Respiratory failure was the most common immediate cause of death (43.4%), followed by dehydration/malnutrition (20.8%), and cardiovascular diseases (9.4%). In adults with DS, the most common cause was respiratory disease (73.3%), infectious and bacterial diseases (4.4%), and diseases of the digestive system (4.4%). Diseases of the respiratory system also formed the largest group of primary causes of death (32.1%; 80.4% was due to pneumonia), followed by neoplasms (17.6%), and diseases of the circulatory system (8.2%). In adults with DS, the main primary cause was also respiratory diseases (51.1%), followed by dementia (22.2%).
American journal on intellectual and developmental disabilities, 2018 · doi:10.1352/1944-7558-123.1.61