People with learning disabilities are suffering from a far greater number of illnesses than had been previously understood, adding to concerns that life-threatening conditions are being routinely missed.
A new study, published in BMJ Open, based on detailed clinical assessments of over 1,000 adults found that nearly all of them suffered from 'multi-morbidity', or the co-existence of different health conditions ranging from obesity, constipation to poor eyesight, with rates far higher than previously thought.
These findings, by the Scottish Learning Disabilities Observatory follow concerns that people with learning disabilities are dying from treatable conditions.
Previous studies in the UK and internationally reporting on multi-morbidity have not gone into the level of detail seen in this research. Dr. Deborah Kinnear, Research Fellow at the Observatory, called for greater awareness amongst clinicians and carers of the types of conditions that are commonly experienced by adults with learning disabilities.
"Understanding both the types of conditions that people with learning disabilities experience and the fact that they are more likely to experience a greater combination of these conditions is vital if we are to provide effective treatment and stop people dying from preventable illnesses. Clinicians and carers may sometimes miss conditions, or misattribute symptoms to the individual's learning disabilities (also known as diagnostic overshadowing). This can be compounded by communication difficulties experienced by people with learning disabilities and the fact that conditions experienced by people with learning disabilities differ to those commonly seen in the general population." Dr. Kinnear said.
This unique study analysed the results of detailed clinical assessments of 1,023 adults with learning disabilities in Scotland. Over 98.7% of people were found to have more than one physical health condition and the average number of conditions for each person was 11 with one person having 28 co-existing health conditions. Some of the most common conditions found among study participants were: visual impairment, obesity, epilepsy, constipation and movement disorders. Many of these conditions are painful, disabling and can be potentially life threatening. But with effective identification and care the majority could have been prevented or treated.
The research was led by the Scottish Learning Disabilities Observatory which is funded by the Scottish Government and based in the Institute of Health and Wellbeing at the University of Glasgow.
Professor Anna Cooper, Director of the Observatory, said: "These findings are important because they highlight critical differences in the pattern of health for the population with learning disabilities, with people in this population experiencing, on average 11 different conditions at any one time. The average age of the people assessed was only 43 years so we are seeing complex combinations of health problems arising for people with learning disabilities across all ages, young and old. These findings should help NHS organisations to provide improved care pathways for people with learning disabilities."
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Prevalence of physical conditions and multimorbidity in a cohort of adults with intellectual disabilities with and without Down syndrome: cross-sectional study. BMJ Open 2018;8:e018292. DOI: 10.1136/bmjopen-2017-018292