Division of Occupational and Environmental Medicine, Faculty of Medicine, Lund University, SE-221 00, Lund, Sweden.
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
BMC Geriatr. 2017 Nov 23;17(1):272. doi: 10.1186/s12877-017-0658-2.
Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID) have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups.
This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936). We also established a same-sized referent cohort from the general population matched by sex and year of birth. Information on diagnoses of diabetes mellitus and hypertension, and prescription of drugs for these disorders, were collected from national registers for the period 2006-2012. The two cohorts were compared using generalized linear models (GLM).
People with ID were 20% more likely than the general population to have a diagnosis of diabetes mellitus, and 26% more likely to have prescription of drugs for diabetes mellitus. People in the general population were 81% more likely to have a diagnosis of hypertension, and 9% more likely to have a prescription of drugs for hypertension. Among those with diabetes, ID was associated with higher occurrence of prescription of insulin combination drugs and sulfonylureas, but lower occurrence of prescription of dipeptidyl peptidase (DPP) 4-inhibitors and exenatide/liraglutide. Among those with hypertension, ID was associated with higher occurrence of prescription of diuretics, but lower occurrence of prescription of calcium channel blockers and angiotensin II antagonists.
Treatment regimens among people with ID tended to include older types of medication compared with what was prescribed in the general population. To ensure that this is medically appropriate and not due to failure to update the treatment regimen, it is important to investigate if the people with ID and diabetes mellitus or hypertension are subjected to the same regular drug reviews that are recommended for older adults in general.
糖尿病和高血压是心血管疾病的风险因素，心血管疾病是世界上最常见的死亡原因。有智力障碍 (ID) 的人这两种疾病的发病率都很高。本研究的目的是描述和比较患有 ID 的老年人与普通人群中同龄人的糖尿病和高血压的患病率比，并描述和比较这两组人群的治疗模式。
这是一项瑞典基于登记的研究，我们建立了一个年龄在 55 岁以上且在 2012 年接受 ID 支持的人群队列（n=7936）。我们还从普通人群中建立了一个相同大小的参照队列，按性别和出生年份匹配。从 2006 年至 2012 年的国家登记册中收集了关于糖尿病和高血压的诊断以及这些疾病药物治疗的信息。使用广义线性模型（GLM）比较两个队列。
与普通人群相比，ID 患者患糖尿病的可能性高 20%，服用糖尿病药物的可能性高 26%。普通人群患高血压的可能性高 81%，服用高血压药物的可能性高 9%。在患有糖尿病的人群中，ID 与胰岛素联合药物和磺酰脲类药物的处方频率更高相关，但与二肽基肽酶 (DPP) 4 抑制剂和艾塞那肽/利拉鲁肽的处方频率更低相关。在患有高血压的人群中，ID 与利尿剂处方频率更高相关，但与钙通道阻滞剂和血管紧张素 II 拮抗剂的处方频率更低相关。
与普通人群相比，ID 患者的治疗方案往往包括更老的药物类型。为了确保这是医学上适当的，而不是由于未能更新治疗方案，重要的是要调查患有糖尿病或高血压的 ID 患者是否接受了与一般老年人推荐的相同的定期药物审查。
