Ipse de Bruggen, Expertise Centre Nootdorp, Nootdorp, The Netherlands.
J Intellect Disabil Res. 2013 Jul;57(7):681-5. doi: 10.1111/j.1365-2788.2012.01567.x. Epub 2012 May 8.
Epidemiological information on age-related cardiovascular disease in people with intellectual disability (ID) is scarce and inconclusive. We compared prevalence and incidence of cerebrovascular accident and myocardial infarction over age 50 in a residential population with ID to that in a general practice population.
A retrospective descriptive study was conducted, based on medical records of 510 persons with ID and 823 general practice patients, aged 50 years and over.
Lifetime prevalences after age 50 were similar in both populations: 5.7% (95% CI 4.0-8.1%) in persons with ID and 4.4% (95% CI 3.1-6.0%) in the general population (Pearson chi-square 1.17, P = 0.279). Incidence per gender was similar between cohorts (men P = 0.86, women P = 0.36). There was no difference in incidence rates between the ID and control groups [relative risk = 1.5 (95% CI 0.9-2.4)].
Prevalence and incidence of myocardial infarction and cerebrovascular accident in ageing persons with ID do not appear different from those in the general population. It has to be taken into account that underdiagnosis and selection bias towards a more disabled group may have lead to underestimation of age-related cardiovascular morbidity, and the higher age and underrepresentation of Down syndrome to overestimation.
关于 50 岁以上智力障碍(ID)人群中与年龄相关的心血管疾病的流行病学信息稀缺且不一致。我们比较了居住在 ID 人群中年龄超过 50 岁的脑血管意外和心肌梗死的患病率和发病率与普通实践人群中的患病率和发病率。
这是一项回顾性描述性研究,基于 510 名 ID 患者和 823 名普通实践患者的医疗记录,年龄均在 50 岁以上。
50 岁以后的终生患病率在两个群体中相似:ID 人群中为 5.7%(95%CI 4.0-8.1%),普通人群中为 4.4%(95%CI 3.1-6.0%)(Pearson chi-square 1.17,P=0.279)。两个队列的性别发病率相似(男性 P=0.86,女性 P=0.36)。ID 组和对照组之间的发病率无差异[相对风险=1.5(95%CI 0.9-2.4)]。
在年龄较大的 ID 人群中,心肌梗死和脑血管意外的患病率和发病率似乎与普通人群没有差异。需要考虑到,诊断不足和选择更残疾的群体可能导致与年龄相关的心血管发病率低估,以及年龄更高和唐氏综合征代表性不足导致发病率高估。