A 3-year follow-up study on cardiovascular disease and mortality in older people with intellectual disabilities.
Heart risk in older adults with ID is common but watchable—cut antipsychotics, weight, and kidney problems early.
01Research in Context
What this study did
Reeve et al. (2016) followed older adults with intellectual disability for three years. They counted who had heart attacks, strokes, or other heart events. They also tracked who died and looked for warning signs at the start.
What they found
About six in every hundred adults had a new heart event. People taking atypical antipsychotics, those who were obese, and anyone with past heart trouble were more likely to join that group. Low body weight and kidney disease raised the risk of dying.
How this fits with other research
McSweeney et al. (2000) watched adults with ID for 35 years and saw mild ID life spans now match the general public. F et al. shorten the lens to three years and say heart risk also looks typical, so the longer life is not risk-free.
Maïano et al. (2014) showed exercise programs can cut weight in youth with ID. F et al. add the next chapter: extra weight in older age predicts heart events, giving you a reason to keep those youth programs running.
Petrovic et al. (2016) found that nearly half of inpatients on antipsychotics had metabolic syndrome. F et al. echo the warning in the community: the same drugs drive heart events, not just lab numbers.
Why it matters
You now know that heart risk in older clients with ID mirrors the general senior population. Add antipsychotic review, weight checks, and kidney labs to your annual care plan. A simple referral to a dietitian or psychiatrist can prevent a cardiac emergency.
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02At a glance
03Original abstract
BACKGROUND: With increasing longevity and a similar or increased prevalence of cardiovascular disease risk factors (as compared to the general population), people with intellectual disabilities (IDs) are at risk of developing cardiovascular disease. However, prospective studies on incidence and influencing factors of cardiovascular disease and mortality are lacking. METHODS: A three year follow-up study was undertaken to study the incidence and symptoms at presentation of myocardial accident, stroke and heart failure in older people with ID. Furthermore, the predictive value of cardiovascular disease risk factors on myocardial accident, stroke and heart failure and on all-cause mortality were studied. The baseline group consisted of the 1050 participants, aged 50 years and over, in the Dutch Healthy Ageing and Intellectual Disability (HA-ID) study. Baseline measurements were conducted between November 2008 and July 2010. Three years after baseline, medical files of 790 participants were studied. RESULTS: Cardiovascular disease (myocardial infarction, stroke and heart failure) occurred in 5.9% of the population during 3 year follow-up, and 32% of them died due to the condition. Incidence of myocardial infarction is 2.8 per 1000 personyears, for stroke 3.2 per 1000 personyears and for heart failure 12.5 per 1000 personyears. Incidence of these conditions is probably underestimated, due to atypical symptom presentation. The use of atypical antipsychotics and a history of heart failure were predictive for myocardial infarction. Heart failure was predicted by abdominal obesity, chronic kidney disease and a history of heart failure. A total of cardiovascular disease (myocardial infarction, stroke or heart failure) was predicted by abdominal obesity, a history of stroke and a history of heart failure. A low body-mass index, peripheral arterial disease, chronic kidney disease and inflammation were predictive for 3-year all-cause mortality. CONCLUSION: Incidence of cardiovascular disease in older people with ID is similar to that in the general population. A pro-active assessment and treatment of the presented cardiovascular disease risk factors may reduce cardiovascular disease and mortality in older people with ID.
Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2016.01.020