Feasibility and findings of electrocardiogram recording in older adults with intellectual disabilities: results of the Healthy Ageing and Intellectual Disabilities study

IF 2.1 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research Pub Date : 2024-08-15 DOI:10.1111/jir.13181

M. J. de Leeuw, M. N. Böhmer, M. J. G. Leening, J. A. Kors, P. J. E. Bindels, A. Oppewal, D. A. M. Maes-Festen

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引用次数: 0

Abstract

Background

Older adults with intellectual disabilities (ID) have a high risk of cardiovascular diseases (CVD). At the same time, challenging diagnostic work-up increases the likelihood of underdiagnosis of CVD in this population. To limit this underdiagnosis, it would be beneficial to use objective measures such as the electrocardiogram (ECG). However, little is known about the feasibility of ECG recording and the prevalence of ECG abnormalities in this population. Therefore, the aims of this study were to investigate the feasibility of resting ECG recording, to study the prevalence of ECG abnormalities, and to compare the frequency of ECG abnormalities with medical records in older adults with ID.

Method

A cross-sectional study was performed within a cohort of older adults (≥60 years) with ID as part of the Healthy Ageing and Intellectual Disabilities (HA-ID) study. A resting 12-lead ECG was attempted, and the ECG recording was considered feasible if the recording could be made and if the ECG could be interpreted by a cardiologist and the Modular ECG Analysis System (MEANS). ECGs were assessed for the presence of ECG abnormalities and medical record review was performed. If the cardiologist or MEANS concluded that there was evidence of myocardial infarction, atrial fibrillation or QTc prolongation on the ECG in the absence of this ECG diagnosis in the participant's medical record, this was classified as a previously undiagnosed ECG diagnosis.

Results

ECG recording was feasible in 134 of the 200 participants (67.0%). Of these 134 participants (70.6 ± 5.8 years; 52.2% female), 103 (76.9%) had one or more ECG abnormality, with the most prevalent being prolonged P-wave duration (27.6%), QTc prolongation (18.7%), minor T-wave abnormalities (17.9%), first degree atrioventricular block (12.7%) and myocardial infarction (6.7%). Eight out of 9 (88.9%) myocardial infarctions and all cases of (significant) QTc prolongation (100%) were previously undiagnosed.

Conclusions

This study showed that ECG recording is feasible in the majority of older adults with ID and revealed a substantial underdiagnosis of ECG abnormalities. These results stress the importance of ECG recording and warrant further research into the yield of opportunistic ECG screening in older adults with ID.

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智障老年人心电图记录的可行性和结果：健康老龄化和智障研究的结果。

背景：智障老年人罹患心血管疾病（CVD）的风险很高。同时，高难度的诊断工作增加了这一人群心血管疾病诊断不足的可能性。为了限制这种漏诊，使用心电图（ECG）等客观测量方法将是有益的。然而，人们对心电图记录的可行性以及该人群心电图异常的发生率知之甚少。因此，本研究的目的是调查静息心电图记录的可行性，研究心电图异常的发生率，并将智障老年人心电图异常的频率与医疗记录进行比较：方法：作为健康老龄化和智力残疾（HA-ID）研究的一部分，在一组患有智障的老年人（≥60 岁）中进行了一项横断面研究。研究人员尝试了静息 12 导联心电图，如果心电图能够记录，并且心电图能够由心脏病专家和模块化心电图分析系统 (MEANS) 进行解读，则认为心电图记录是可行的。评估心电图是否存在异常，并对病历进行审查。如果心脏病专家或模块化心电图分析系统（MEANS）认为心电图上存在心肌梗死、心房颤动或 QTc 延长的证据，而参与者的医疗记录中没有该心电图诊断，则将其归类为先前未诊断的心电图诊断：200 名参与者中有 134 人（67.0%）可以进行心电图记录。在这 134 名参与者（70.6 ± 5.8 岁；52.2% 为女性）中，103 人（76.9%）有一种或多种心电图异常，其中最常见的是 P 波持续时间延长（27.6%）、QTc 延长（18.7%）、轻微 T 波异常（17.9%）、一级房室传导阻滞（12.7%）和心肌梗死（6.7%）。9例心肌梗死中的8例（88.9%）和所有（明显）QTc延长的病例（100%）以前都未被诊断出来：这项研究表明，对大多数患有智障的老年人进行心电图记录是可行的，并揭示了心电图异常的严重漏诊。这些结果强调了心电图记录的重要性，值得进一步研究对患有智障的老年人进行机会性心电图筛查的收益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Intellectual Disability Research Multiple-

CiteScore

5.60

自引率

5.60%

发文量

期刊介绍： The Journal of Intellectual Disability Research is devoted exclusively to the scientific study of intellectual disability and publishes papers reporting original observations in this field. The subject matter is broad and includes, but is not restricted to, findings from biological, educational, genetic, medical, psychiatric, psychological and sociological studies, and ethical, philosophical, and legal contributions that increase knowledge on the treatment and prevention of intellectual disability and of associated impairments and disabilities, and/or inform public policy and practice. Expert reviews on themes in which recent research has produced notable advances will be included. Such reviews will normally be by invitation.