Assessment & Research

The prevalence of peripheral arterial disease in middle-aged people with intellectual disabilities.

Zaal-Schuller et al. (2015) · Research in developmental disabilities 2015
★ The Verdict

One in 12 middle-aged adults with ID already has silent PAD—screen early, especially if wheelchair-dependent.

✓ Read this if BCBAs and RBTs serving adults with ID in residential, day-program, or clinic settings.
✗ Skip if Practitioners working only with young children or typically developing clients.

01Research in Context

01

What this study did

Doctors checked adults with intellectual disability for silent peripheral artery disease. They looked at 40- to 59-year-olds in Ireland. A quick ankle blood-pressure test found cases doctors had missed.

02

What they found

One in every 12 adults had undiagnosed PAD. Wheelchair users were the most likely to have it. The disease was hidden; no one had complained of leg pain.

03

How this fits with other research

Morin et al. (2012) already showed adults with ID have more heart disease than the general public. H et al. now zoom in on one silent form: PAD.

de Leeuw et al. (2024) widened the lens. Their 2024 Medicaid data say up to three-quarters of adults with IDD carry chronic heart or vessel problems. The 2015 PAD count is one concrete piece of that bigger picture.

Sawyer et al. (2014) used the same survey trick and found low bone quality in half of adults over 50 with ID. Together these papers prove cross-sectional clinics can uncover hidden conditions in this group.

04

Why it matters

If you support adults with ID, add a five-minute ankle-brachial test at their next annual physical. Catch PAD early, especially in clients who use wheelchairs or rarely walk. Early detection lets you refer for diet, exercise, or medical care before pain or sores start.

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Ask the nurse to add an ankle blood-pressure check at the next annual physical for every adult client over 40.

02At a glance

Intervention
not applicable
Design
other
Sample size
407
Population
intellectual disability
Finding
not reported

03Original abstract

Peripheral arterial disease (PAD) is a manifestation of atherosclerosis below the bifurcation of the abdominal aorta. PAD increases the risk of cardiovascular disease and associated mortality. Little is known about the prevalence of PAD in middle-aged persons with intellectual disabilities (ID). We determined the prevalence of PAD among people with ID aged 40-59 years. Independent associations between PAD and patient and care characteristics were explored. A multi-center cross-sectional observational study was conducted in four care providing agencies for people with ID in the Netherlands. We included 407 participants with mild to profound ID aged 40-59 years, receiving medical care from specialized ID physicians. The ankle-brachial index was used to diagnose PAD. The overall prevalence of PAD was 8.4% (95% CI=6.0-11.4%), with no significant differences between age groups 40-49 years (8.2%) and 50-59 years (8.5%). None of the participants had been diagnosed with PAD prior to this study and only one participant with PAD had PAD-related symptoms (1/34). Wheelchair dependence was independently associated with PAD (OR=5.43). Prevalence of PAD among people with ID is high, which is especially remarkable in age group 40-49 years. Physicians need to be aware of this high prevalence of PAD and the increased risk of cardiovascular disease in (young) people with ID.

Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.10.021