Cardiovascular Disease Incidence and Risk Factors in Older Adults With Intellectual Disabilities: Results of the Healthy Ageing and Intellectual Disabilities Study.

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research Pub Date : 2025-07-01 DOI:10.1111/jir.70004

Marleen J de Leeuw, Mylène N Böhmer, Patrick J E Bindels, Dederieke A M Maes-Festen, Alyt Oppewal

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引用次数: 0

Abstract

Background: Previous research has shown that older adults with intellectual disabilities are at increased risk of cardiovascular diseases (CVD). However, longitudinal studies investigating the actual incidence of CVD and its associated risk factors in this population are limited. Such research is essential for optimising healthcare delivery and informing effective resource allocation. Therefore, this study aimed to examine CVD incidence in older adults with intellectual disabilities and explore its associations with participant characteristics and risk factors.

Method: A prospective longitudinal study was conducted in older adults (≥ 50 years) with intellectual disabilities as part of the Healthy Ageing and Intellectual Disabilities study. Baseline measurements were performed in 2009-2010, with follow-up assessments, including medical record reviews, in 2020-2023. Incidence rates for myocardial infarction (MI), heart failure (HF) and stroke were calculated by sex and 10-year age categories. Competing risk analysis was performed to examine the associations between CVD diagnoses during follow-up and baseline participant characteristics/CVD risk factors, accounting for mortality as a competing risk.

Results: Among 598 participants (62.0 ± 8.5 year; 49.3% female), with a mean follow-up of 8.6 years, incidence rates were 2.3 per 1000 person years for MI, 7.2 for HF, and 5.3 for stroke. Hypertension (HR 3.17; p < 0.001), Down syndrome (HR 2.66; p < 0.01) and antipsychotic use (HR 1.98; p = 0.04) were associated with an increased CVD risk during follow-up.

Conclusions: A lower incidence of MI and similar to higher incidence of HF and stroke were found in older adults with intellectual disabilities than in the general population. Further research, including a focus on the association of CVD incidence with Down syndrome, is needed. Meanwhile, proactive assessment and management of CVD risk factors, such as hypertension and antipsychotic use, are important for improving cardiovascular health in older adults with intellectual disabilities.

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智力残疾老年人心血管疾病发病率和危险因素：健康老龄化和智力残疾研究的结果

背景：先前的研究表明，患有智力残疾的老年人患心血管疾病（CVD）的风险增加。然而，调查心血管疾病实际发病率及其相关危险因素的纵向研究在这一人群中是有限的。此类研究对于优化医疗保健服务和告知有效的资源分配至关重要。因此，本研究旨在研究老年智力残疾患者的心血管疾病发病率，并探讨其与参与者特征和危险因素的关系。方法：对智力残疾老年人（≥50岁）进行前瞻性纵向研究，作为健康老龄化和智力残疾研究的一部分。2009-2010年进行了基线测量，并在2020-2023年进行了后续评估，包括医疗记录审查。心肌梗死（MI）、心力衰竭（HF）和中风的发病率按性别和10岁年龄组计算。进行竞争风险分析以检查随访期间CVD诊断与基线参与者特征/CVD危险因素之间的关系，并将死亡率作为竞争风险考虑在内。结果：598名参与者(62.0±8.5岁；49.3%女性)，平均随访8.6年，心肌梗死发病率为每1000人年2.3例，心衰发病率为7.2例，脑卒中发病率为5.3例。高血压(HR 3.17；结论：与一般人群相比，老年智力障碍患者心肌梗死发生率较低，心衰和卒中发生率较高。需要进一步的研究，包括关注心血管疾病发病率与唐氏综合征的关系。同时，积极评估和管理心血管疾病的危险因素，如高血压和抗精神病药物的使用，对于改善老年智力残疾患者的心血管健康非常重要。

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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.