Ng N, Sandberg M, Ahlström G
Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
Centre for Demographic and Ageing Research, Umeå University, Sweden.
J Intellect Disabil Res. 2015 Dec;59(12):1155-67. doi: 10.1111/jir.12219. Epub 2015 Aug 26.
The expected increase in longevity of individuals with intellectual disabilities (ID) in many countries of the world is a direct result of medical and social advances, which have also extended the longevity of the general population. It is important to assess the need for social services for people with ID across different administrative levels to ensure sufficient resources are allocated to where they are most needed. This study estimates the annual prevalence of older people with ID from 2004 to 2012 and in different counties and municipalities in Sweden, by sex and age group; identifies proxy indicators related to the care of older people with ID in different counties in 2012 in Sweden and analyses the spatial distribution and clustering of municipalities with a high prevalence of older people with ID.
Individuals with ID were identified through the national register based on the Swedish Act concerning Support and Service for Persons with Certain Functional Impairments (the LSS act) and the national death register. This study focuses on older individuals aged 55+ during the period of 2004-2012. The estimated prevalence was calculated at the county and municipality level and plotted on a municipality-level map. Moran's I statistics was used to identify any spatial clustering of municipalities with a large number of individuals with ID.
The prevalence of ID among older individuals aged 55+ in Sweden increased from 2004 to 2012. The prevalence was consistently higher among men, and the gender gap increased slightly in recent years. Age-specific prevalence estimates showed ID to be higher in younger age groups, and the gender gap decreased in older age groups. The prevalence was higher in northern counties in Sweden (over 500 individuals per 100 000 population aged 55+). Higher prevalence areas were clustered in northern municipalities, whereas municipalities with high prevalence of older individuals with ID in the middle and southern regions of Sweden demonstrated a more widespread distribution.
The existence of clusters of counties with a high prevalence of older individuals with ID necessitates further assessment of how resources have been allocated to different counties and municipalities in Sweden. Investigations of the quality of social services provided to individuals with ID across different counties in Sweden are warranted. It is important to ensure that high quality supports are being provided to older individuals with ID in order to grant them the same right to healthy ageing as their counterparts living without ID throughout their life course.
世界上许多国家智力残疾（ID）患者预期寿命的增加是医学和社会进步的直接结果，这些进步也延长了普通人群的寿命。评估不同行政级别上ID患者对社会服务的需求很重要，以确保将足够的资源分配到最需要的地方。本研究估计了2004年至2012年瑞典不同县和市中ID老年患者的年度患病率，按性别和年龄组划分；确定了2012年瑞典不同县中与ID老年患者护理相关的代理指标，并分析了ID老年患者高患病率市的空间分布和聚集情况。
根据瑞典《关于对某些功能障碍者的支持和服务的法案》（LSS法案）和国家死亡登记册，通过国家登记册识别ID患者。本研究关注2004 - 2012年期间55岁及以上的老年人。在县和市一级计算估计患病率，并绘制在市级地图上。使用莫兰指数统计来识别ID患者数量众多的市的任何空间聚集情况。
2004年至2012年，瑞典55岁及以上老年人中ID的患病率有所增加。男性患病率一直较高，近年来性别差距略有增加。特定年龄患病率估计显示，较年轻年龄组中ID患病率较高，而较年长年龄组中性别差距减小。瑞典北部各县的患病率较高（每10万55岁及以上人口中超过500人）。高患病率地区聚集在北部各市，而瑞典中部和南部地区ID老年患者高患病率的市分布更为广泛。
ID老年患者高患病率县群的存在需要进一步评估瑞典不同县和市的资源分配情况。有必要对瑞典不同县向ID患者提供的社会服务质量进行调查。重要的是要确保向ID老年患者提供高质量的支持，以便让他们在整个生命过程中享有与非ID同龄人相同的健康老龄化权利。
