Predictors, including blood, urine, anthropometry, and nutritional indices, of all-cause mortality among institutionalized individuals with intellectual disability.
Basic blood tests plus daily walking can lengthen life for adults with ID in residential care.
01Research in Context
What this study did
Hiroko and colleagues tracked 316 adults living in a state facility. All had intellectual disability. The team pulled blood and urine tests from medical charts. They also recorded height, weight, and epilepsy status. Then they waited 18.6 years to see who died.
The goal was simple: which routine lab values warn of earlier death in this group?
What they found
Four red flags stood out. Being male, high cholesterol, a liver test called thymol turbidity, and epilepsy each raised the risk of dying sooner. These factors stayed dangerous even after the researchers adjusted for age.
The message: basic lab work can flag life-shortening risk in adults with ID who live in congregate care.
How this fits with other research
Simpson et al. (2001) ran a longer 35-year Finnish cohort. They also found heart and lung disease top the death list in ID. Hiroko’s lab markers echo that same cardiovascular story.
Murthy et al. (2021) took the next step. In 1,618 adults with IDD they showed obesity and diabetes drive high cholesterol. Together the papers form a chain: obesity → cholesterol → earlier death.
Diaz (2020) adds hope. Leisure walking as little as 10 min a day cuts mortality. So the same group that shows lethal labs also gains years from simple movement.
Why it matters
You can act on these numbers today. Ask the doctor for annual cholesterol and liver panels. Schedule epilepsy reviews. Start walking clubs or dance sessions in the residence. Small labs, small steps, bigger lifespan.
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02At a glance
03Original abstract
As the life expectancy of people with intellectual disability (ID) increases, it is becoming necessary to understand factors affecting survival. However, predictors that are typically assessed among healthy people have not been examined. Predictors of all-cause mortality, including blood, urine, anthropometry, and nutritional indices, were examined among institutionalized people with ID. This retrospective cohort study involved 316 participants (191 males, 125 females; mean age, 36.5 ± 10.5 years) at a public facility for people with ID in Ibaraki Prefecture, Japan. During the follow-up from the examination day in 1984-1992 through December 31, 2007 (mean follow-up, 18.6 years), 44 deaths occurred. Mean age at death was 47.1 ± 10.0 years (range, 22.3-65.3 years). Early deaths within three years (n = 4) were treated as censored cases. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality. Sex- and age-adjusted analysis (p<0.15) revealed positive associations with mortality for high serum cholesterol, high thymol turbidity test (TTT), and glucosuria and negative associations with mortality for high serum albumin, high uric acid, high potassium, high calcium, and high systolic blood pressure. Multivariate analysis revealed that male sex (HR, 4.11; 95% CI, 1.59-10.59), high serum cholesterol (1.01; 1.00-1.02), high serum TTT (1.21; 1.03-1.41), and epilepsy significantly increased the mortality risk. The results indicate that the predictors of life expectancy for people with ID included both factors that are shared with healthy people (male sex, high serum cholesterol) and factors specific to people with disabilities (high serum TTT and epilepsy).
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.10.006