Physical health issues in adults with severe or profound intellectual and motor disabilities: a systematic review of cross-sectional studies.
Expect epilepsy in 7 of every 10 adults with severe or profound ID and motor problems—plan daily seizure, vision, and bowel checks.
01Research in Context
What this study did
Bao et al. (2017) pooled every cross-sectional study they could find on physical health in adults with severe or profound intellectual and motor disabilities (SPIMD).
They screened medical databases and pulled numbers on how often conditions like epilepsy, vision loss, and spasticity show up in this group.
What they found
Seven out of ten adults with SPIMD have epilepsy.
Vision trouble, tight muscles (spasticity), and other problems also appear far more often than in people with milder disabilities.
How this fits with other research
Gaynor et al. (2008) saw only 18 % epilepsy in a broad ID sample. The 70 % rate looks like a clash until you notice they studied everyone with ID, while A et al. focused only on the most severe cases who also cannot walk or feed themselves.
van Timmeren et al. (2016) counted a mean of 12 health problems per person in 99 adults with SPIMD. That real-world chart review is one of the very studies the 2017 review swallows to reach its big epilepsy number.
van der Miesen et al. (2024) later showed that adults with profound ID plus epilepsy land in the hospital for constipation more than anyone else. The review’s high constipation numbers now make sense—those same risk factors were already hiding in the data.
Why it matters
If you write care plans or train staff, treat epilepsy, vision checks, and bowel programs as routine, not optional. Screen for all three at every visit, and track small changes early. This prevents crises and cuts hospital trips.
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02At a glance
03Original abstract
BACKGROUND: People with severe or profound intellectual and motor disabilities (SPIMD) encounter several risk factors associated with higher mortality rates. They are also likely to experience a cluster of health problems related to the severe brain damage/dysfunction. In order to earlier detect physical health problems in people with SPIMD, first of all, knowledge regarding the prevalence of physical health problems is necessary. The aim of this systematic review was to methodically review cross-sectional studies on the prevalence of various types of physical health problems in adults with SPIMD. METHOD: MedLine/PubMed, CINAHL, Embase, PsycINFO and Web of Science were searched for studies published between 2004 and 2015. The quality of the incorporated studies was assessed utilising an adjusted 'risk of bias tool' for cross-sectional studies. To estimate the prevalence of the health problems, the proportion and corresponding confidence interval were calculated. A random effect meta-analysis was performed when at least three studies on a specific health problem were available. RESULTS: In total, 20 studies were included and analysed. In the meta-analysis, a homogeneous prevalence rate of 70% (CI 65-75%) was determined for epilepsy. Heterogeneous results were ascertained in the meta-analysis for pulmonary/respiratory problems, hearing problems, dysphagia, reflux disease and visual problems. For the health problems identified in two studies or in a single study, the degree of evidence was low. As expected, higher prevalence rates were found in the current review compared with people with ID for visual problems, epilepsy and spasticity. CONCLUSION: This review provides an overview of the current state of the art research on the prevalence of health problems in adults with SPIMD. There is a substantial need for comprehensive epidemiological data in order to find clusters of health problems specific for people with SPIMD. This would provide insight into the excess morbidity associated with SPIMD.
Journal of intellectual disability research : JIDR, 2017 · doi:10.1111/jir.12296