Causes of mortality among adults with Down syndrome before and after the COVID-19 pandemic in Spain

IF 2.1 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research Pub Date : 2023-10-01 DOI:10.1111/jir.13096

Beatriz Sánchez Moreno, Laura Adán-Lirola, Javier Rubio-Serrano, Diego Real de Asúa

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Abstract

Background

The life expectancy of people with Down syndrome (DS) is limited by Alzheimer's disease (AD)-related deaths, mainly due to respiratory infections. The emergence of the COVID-19 pandemic could have changed known, past trends in mortality in this population. We analysed the differences in causes of mortality between individuals with DS deceased before and after the onset of the pandemic.

Method

This is a cross-sectional study of adults with DS recruited at a tertiary, university outpatient clinic in Madrid, Spain. Demographic and clinical data were retrospectively collected from their medical records, including information on their deaths, if any.

Results

Five hundred seventy-two adults were included in the study, and 67 (11.7%) died. The main cause of death was respiratory infections, which occurred in 36 participants [9 (45.0%) before, and 27 (58.7%) after the appearance of COVID-19]. No significant differences were found in the determinants of pre-pandemic and post-pandemic death after adjusting for age and AD, except for an association between the use of psychotropic medication and death in the post-pandemic period (odds ratio: 2.24; 95% confidence interval: 1.04–4.82). Vaccination against COVID-19 showed a marked protective effect against mortality (odds ratio: 0.0002; 95% confidence interval: 6.7e10⁻⁶ to 0.004).

Conclusions

The appearance of COVID-19 has not impacted the overall trend of increase in mean age of death of adults with DS in our milieu, probably thanks to the very important protective effect of vaccination, which supports prioritising people with DS in future immunisation campaigns. The association between psychotropic medication use and mortality requires further exploration.

Abstract Image

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西班牙新冠肺炎大流行前后唐氏综合征成人死亡率的原因。

背景：唐氏综合症（DS）患者的预期寿命受到阿尔茨海默病（AD）相关死亡的限制，主要是由于呼吸道感染。新冠肺炎大流行的出现可能改变了这一人群过去已知的死亡率趋势。我们分析了DS患者在疫情爆发前后死亡原因的差异。方法：这是一项横断面研究，研究对象是在西班牙马德里一所三级大学门诊招募的DS成年人。从他们的医疗记录中回顾性收集人口统计学和临床数据，包括他们的死亡信息（如果有的话）。结果：五百七十二名成年人被纳入研究，67人（11.7%）死亡。死亡的主要原因是呼吸道感染，这发生在36名参与者中[9人（45.0%）在新冠肺炎出现之前，27人（58.7%）在出现之后]。在调整年龄和AD后，在大流行前和大流行后死亡的决定因素中没有发现显著差异，除了精神药物的使用与大流行后死亡之间的关联（比值比：2.24；95%置信区间：1.04-4.82）。接种新冠肺炎疫苗对死亡率显示出显著的保护作用在我们的环境中，患有DS的成年人的平均死亡年龄，这可能要归功于疫苗接种的非常重要的保护作用，它支持在未来的免疫运动中优先考虑患有DS的人。精神药物使用与死亡率之间的关系需要进一步探讨。

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.