Department of Public Health Sciences, Queen's University & Ongwanada, Kingston, Ontario, Canada.
Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada.
Ann Epidemiol. 2018 Apr;28(4):220-224. doi: 10.1016/j.annepidem.2018.01.010. Epub 2018 Jan 31.
To identify factors associated with the rate of deficit accumulation in a population of adults with intellectual and developmental disabilities (IDD).
A longitudinal analysis of administratively held clinical data collected at routine home care assessments across Ontario (Canada) using the Resident Assessment Instrument for Home Care (RAI-HC) was conducted using a cohort comprised of 5074 adults with IDD 18-99 years of age who had at least two home care assessments between April 1, 2003 and March 31, 2015. Rates of deficit accumulation were calculated across variables of interest. Incidence rate ratios and 95% confidence intervals are presented. Negative binomial regression models using a generalized estimating equation (GEE) approach were developed.
Increasing age, Down syndrome, and living in a group home were significant predictors of deficit accumulation. Rates of deficit accumulation tended to be higher among prefrail and frail individuals; however, impaired cognition and impairment in activities of daily living were associated with slower deficit accumulation. The relationship between provision of nursing and therapy services and deficit accumulation is unclear.
Frailty should be monitored among adults with IDD starting at age 40 years, those with Down syndrome, and those who live in group homes.
确定与智力和发育障碍（IDD）成年人人群中缺陷积累速度相关的因素。
对安大略省（加拿大）常规家庭护理评估中使用居民评估工具-家庭护理版（RAI-HC）收集的行政临床数据进行了纵向分析，该分析使用了一个包含 5074 名年龄在 18-99 岁之间的 IDD 成年人的队列，这些成年人在 2003 年 4 月 1 日至 2015 年 3 月 31 日期间至少有两次家庭护理评估。在感兴趣的变量上计算了缺陷积累率。报告了发病率比和 95%置信区间。使用广义估计方程（GEE）方法开发了负二项式回归模型。
年龄增长、唐氏综合征和居住在集体之家是缺陷积累的重要预测因素。在虚弱和脆弱的个体中，缺陷积累的速度往往更高；然而，认知障碍和日常生活活动能力受损与缺陷积累速度较慢相关。护理和治疗服务的提供与缺陷积累之间的关系尚不清楚。
应从 40 岁开始监测 IDD 成年人、唐氏综合征患者和居住在集体之家的人的虚弱情况。
