Patterns of multimorbidity in people with severe or profound intellectual and motor disabilities.
In adults with SPIMD, visual loss, constipation, epilepsy, and spasticity form one predictable cluster—screen for all four together.
01Research in Context
What this study did
Bao et al. (2017) mapped which health problems show up together in adults with severe or profound intellectual and motor disabilities (SPIMD).
They looked for clusters, not single issues. The team wanted to know what combinations a clinician should expect.
What they found
Four conditions travel as a pack: visual loss, constipation, epilepsy, and spasticity with scoliosis.
More than one in three adults with SPIMD carried this exact cluster.
How this fits with other research
van Timmeren et al. (2016) counted the same four problems in medical records first. The new paper shows they are linked, not just common.
McCarron et al. (2013) saw mental-health clusters in older adults with any ID. The SPIMD group flips the pattern: sensory-motor troubles dominate instead. Age and severity explain the difference.
Hermans et al. (2014) widened the lens to adults over 50 with any ID and still found high multimorbidity. The SPIMD cluster is an early, severe slice of that wider picture.
Why it matters
When you write a care plan for an adult with SPIMD, screen for all four conditions at once. If one is present, check the other three. Build one monitoring schedule, not four separate referrals. This cuts missed diagnoses and saves chair time.
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02At a glance
03Original abstract
BACKGROUND: People with severe or profound intellectual and motor disabilities (SPIMD) experience multimorbidity and have complex health needs. Multimorbidity increases mortality, decreases functioning, and negatively influences quality of life. Information regarding patterns of multimorbidity in people with SPIMD may lead to proactive prevention, specifically detection and treatment of physical health problems at an early stage and prevention of secondary complications. AIM: The aim of this study was to explore patterns of multimorbidity in individuals with SPIMD. METHODS AND PROCEDURES: Data from medical records and care plans on reported physical health problems of 99 adults with SPIMD were analysed. To explore the co-occurrence of physical health problems, cross tabulations and a 5-set Venn Diagram were used. OUTCOMES AND RESULTS: The most common combination of two physical health problems comprise the most prevalent physical health problems, which included visual impairment, constipation, epilepsy, spasticity, and scoliosis. These five issues occurred as a multimorbidity combination in 37% of the participants. In 56% of the participants a multimorbidity combination of four health problems emerged, namely constipation, visual impairment, epilepsy, and spasticity. CONCLUSIONS AND IMPLICATIONS: People experiencing SPIMD have interrelated health problems. As a consequence, a broad variety of potential interactions between physical health problems and their treatments may occur. Identifying multimorbidity patterns can provide guidance for accurate monitoring of persistent health problems and, early detection of secondary complications. However, the results require confirmation with larger samples in further studies.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.05.002