Department of Gerontology and Geriatrics, Montpellier University Hospital, MUSE University, Montpellier, France.
CESP, INSERM U1178, Centre de recherche en Epidemiologie et Santé des Populations, Villejuif, France.
Autism. 2023 Apr;27(3):762-777. doi: 10.1177/13623613221121623. Epub 2022 Sep 2.
Multimorbidity relates to having multiple chronic health conditions. It is a risk factor for poor health and reduces life expectancy. Autistic people have multiple chronic health conditions and die prematurely, especially if they have an intellectual disability (autism spectrum disorder and intellectual disability). Certain pathophysiological processes observed in autism spectrum disorder are common to those related to the genesis and/or maintenance of multimorbidity. Furthermore, multimorbidity could be helpful in better identifying patient subgroups in autism spectrum disorder. It is therefore essential to better characterize multimorbidity and its consequences in the subgroup of autism spectrum disorder + intellectual disability individuals to offer them personalized care. We conducted a preliminary study of 63 autism spectrum disorder + intellectual disability adults to classify them according to their multimorbidity and search for a specific combination of chronic health conditions. We observed high and early multimorbidity in this sample and identified four classes of participants, distinguished by their multimorbidity status, independence and number of treatments. In addition, we observed a dominant combination of multimorbidity in our sample, combining immune dysfunction and gastrointestinal disorders, neurological and joint diseases. These findings support the hypothesis that an altered gut-brain relationship is involved in the risk of autism spectrum disorder, its outcome, and its association with chronic health conditions. Although larger studies are needed, our results suggest that subgroups of autism spectrum disorder + intellectual disability individuals can be identified based on their multimorbidity and potentially different ageing trajectories. A more comprehensive and personalized approach is needed to reduce the burden of multimorbidity and increase the quality of life and life expectancy in autism spectrum disorder/ intellectual disability.
共病是指患有多种慢性健康问题。它是健康状况不佳和预期寿命缩短的一个风险因素。自闭症患者患有多种慢性健康问题，并且过早死亡，尤其是如果他们同时患有智力障碍（自闭症谱系障碍和智力障碍）。在自闭症谱系障碍中观察到的某些病理生理过程与共病的发生和/或维持有关。此外，共病可以帮助更好地识别自闭症谱系障碍患者的亚组。因此，必须更好地描述自闭症谱系障碍亚组中的共病及其后果，为他们提供个性化的护理。我们对 63 名自闭症谱系障碍和智力障碍成年人进行了初步研究，根据他们的共病情况对他们进行分类，并寻找慢性健康状况的特定组合。我们观察到该样本中存在高度和早期的共病，并确定了四个参与者群体，这些群体通过他们的共病状况、独立性和治疗数量来区分。此外，我们在样本中观察到了一种占主导地位的共病组合，即免疫功能障碍和胃肠道疾病、神经和关节疾病相结合。这些发现支持了这样一种假设，即肠道-大脑关系的改变可能与自闭症谱系障碍的风险、其结果以及与慢性健康状况的关联有关。尽管需要更大的研究，但我们的研究结果表明，可以根据自闭症谱系障碍和智力障碍患者的共病情况来确定其亚组，并且他们可能具有不同的衰老轨迹。需要采取更全面和个性化的方法来减轻共病负担，提高自闭症谱系障碍/智力障碍患者的生活质量和预期寿命。
