Department of Sociology and Aging Studies Institute, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA.
Department of Physical Medicine and Rehabilitation, SUNY Upstate Medical University, Syracuse, NY, USA.
J Intellect Disabil Res. 2021 Jan;65(1):47-59. doi: 10.1111/jir.12790. Epub 2020 Oct 12.
Prior studies report that adults with intellectual disability (ID) have cause of death patterns distinct from adults in the general population but do not provide comparative analysis by specific causes of death.
Data are from the National Vital Statistics System 2005-2017 US Multiple Cause-of-Death Mortality files. We utilised adjusted odds ratios to identify causes of death that were more common for adults whose death certificate indicated ID (N = 22 512) than for adults whose death certificate did not indicate ID (N = 32 738 229), controlling for severity level of ID. We then examine the associations between biological sex and race-ethnicity and causes of death solely among adults with ID.
The leading cause of death for adults with and without ID indicated on their death certificate was heart disease. Adults with ID, regardless of the severity of the disability, had substantially higher risk of death from pneumonitis, influenza/pneumonia and choking. Adults with mild/moderate ID also had higher risk of death from diabetes mellitus. Differences in cause of death trends were associated with biological sex and race-ethnicity.
Efforts to reduce premature mortality for adults with ID should attend to risk factors for causes of death typical in the general population such as heart disease and cancer, but also should be cognisant of increased risk of death from choking among all adults with ID, and diabetes among adults with mild/moderate ID. Further research is needed to better understand the factors determining comparatively lower rates of death from neoplasms and demographic differences in causes of death among adults with ID.
先前的研究报告称,智障成年人的死亡原因模式与普通人群中的成年人不同,但没有按具体死因进行比较分析。
数据来自美国国家生命统计系统 2005-2017 年的多死因死亡率文件。我们利用调整后的优势比来确定死亡证明上注明智障的成年人(N=22512)比死亡证明上未注明智障的成年人(N=32738229)更常见的死因,同时控制智障严重程度。然后,我们仅在智障成年人中检查生物性别和种族-民族与死因之间的关联。
有智障和无智障成年人死亡证明上的主要死因是心脏病。无论残疾程度如何,智障成年人死于肺炎、流感/肺炎和窒息的风险都大大增加。轻度/中度智障成年人死于糖尿病的风险也更高。死因趋势的差异与生物性别和种族-民族有关。
为减少智障成年人的过早死亡率,应关注与心脏病和癌症等普通人群中典型死因相关的风险因素,但也应认识到所有智障成年人窒息死亡的风险增加,以及轻度/中度智障成年人糖尿病死亡的风险增加。需要进一步研究以更好地了解决定肿瘤发病率相对较低的因素以及智障成年人死因的人口统计学差异。