Association of Intellectual Disability With All-Cause and Cause-Specific Mortality in Sweden

Hirvikoski, Tatja; Boman, Magnus; Tideman, Magnus; Lichtenstein, Paul; Butwicka, Agnieszka

doi:10.1001/jamanetworkopen.2021.13014

Cited by 47 publications

(55 citation statements)

References 48 publications

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“…Medical progress has led to a decrease of mortality, as well as severe cerebral palsy [1][2][3][4]. Meanwhile, childhood follow-up studies reveal altered cognitive outcomes, with high prevalence of executive function and neuropsychiatric disorders [4,5]. Schooling is frequently impaired, and requires special educational support.…”

Section: Introductionmentioning

confidence: 99%

Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption

et al. 2022

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Preterm birth disrupts the in utero environment, preventing the brain from fully developing, thereby causing later cognitive and behavioral disorders. Such cerebral alteration occurs beneath an anatomical scale, and is therefore undetectable by conventional imagery. Prematurity impairs the microstructure and thus the histological process responsible for the maturation, including the myelination. Cerebral MRI diffusion tensor imaging sequences, based on water’s motion into the brain, allows a representation of this maturation process. Similarly, the brain’s connections become disorganized. The connectome gathers structural and anatomical white matter fibers, as well as functional networks referring to remote brain regions connected one over another. Structural and functional connectivity is illustrated by tractography and functional MRI, respectively. Their organizations consist of core nodes connected by edges. This basic distribution is already established in the fetal brain. It evolves greatly over time but is compromised by prematurity. Finally, cerebral plasticity is nurtured by a lifetime experience at microstructural and macrostructural scales. A preterm birth causes a negative and early disruption, though it can be partly mitigated by positive stimuli based on developmental neonatal care.

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Section: Introductionmentioning

confidence: 99%

Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption

et al. 2022

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“…In the current study, malignant neoplasm was the second most common cause of death in people with ID, followed by respiratory diseases. Studies by Patja et al [24] (Finnish), Glover et al [21] (United Kingdom), and Hirvikoski et al [25] (Swedish) reported similar results on the common causes of death in people with ID.…”

Section: Discussionmentioning

confidence: 61%

Mortality rate and cause among people with intellectual disabilities in South Korea: A nationwide representative cross-sectional study from 2015 to 2019

Kim

Kwon

et al. 2022

PLOS Glob Public Health

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People with intellectual disabilities (ID) age faster and have a higher prevalence of degenerative diseases. The aim of this study was to identify the patterns/ causes of death among people with ID. We conducted a nationwide, retrospective, cross-sectional study of people with ID in South Korea. The database was compiled by merging data of people registered with ID, based on the 2015–2019 Standards from the Ministry of Health and Welfare, with the cause of death data published by the Korea National Statistical Office. The International Classification of Diseases-10 (ICD-10) was used to categorize causes of death. The mortality and standardized mortality rates were calculated and major causes of death were analyzed. As of 2019, the mortality rate of people with ID in South Korea was 784.6. The rate showed an irregular pattern, increasing or decreasing year by year (increasing from 725 in 2015 to 834 in 2018). The mortality rate of people with ID was approximately 1.4 times higher than the general population; the standardized mortality rate was 3.2 times higher. The main causes of death (48%) in people with ID were, in order of prevalence, circulatory diseases (cerebrovascular disease), neoplasms (malignant neoplasms of the digestive system), and diseases of the respiratory system (pneumonia). The leading causes of death (>60%) in the general population were, in order of prevalence, neoplasms, diseases of the circulatory system, and respiratory system diseases. An accurate understanding of the causes of death of people with ID is important to promote the development and application of health promotion programs and management thereof.

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“…[7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] A systematic review highlighted that many studies lacked baseline data on sex and age, and not all report age-specific death rates, 5, whilst very few report on cause of death, or on avoidable deaths. Two of the studies focused only on young people, aged 18+ 22 , and aged 20+ 8 . A few large-scale data linkage studies have investigated mortality in children and young people with and without intellectual disabilities.…”

Section: Introductionmentioning

confidence: 99%

“…[23][24] Only three previous studies have reported on avoidable mortality among children and young people with intellectual disabilities (one of which only focused on young people aged 18+ 19 and one of which did not present numeric data 7 ), 7,8,22 and only two have reported on deaths from treatable mortality. 7,22 These studies all found higher rates of deaths from avoidable or treatable mortality in the intellectual disabilities population. A data linkage study using the pupil census in Scotland found avoidable mortality was approximately 3.6 times higher for children and young people with intellectual disabilities compared with peers, although this figure was based on low numbers and was therefore classed as 'unreliable' by the authors.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6] Few studies have reported on mortality specifically in children and young people with intellectual disabilities. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] A systematic review highlighted that many studies lacked baseline data on sex and age, and not all report age-specific death rates, 5, whilst very few report on cause of death, or on avoidable deaths. Two of the studies focused only on young people, aged 18+ 22 , and aged 20+ 8 .…”

Section: Introductionmentioning

confidence: 99%

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Rates, causes and predictors of all-cause and avoidable mortality in 163,686 children and young people with and without intellectual disabilities: A record linkage national cohort study

Hughes-McCormack

Rydzewska

Cooper

et al. 2022

Preprint

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Objectives: To investigate mortality rates and associated factors, and avoidable mortality, in children/young people with intellectual disabilities. Design: Retrospective cohort; individual record-linked data between Scotlands 2011 Census to 9.5 years of National Records for Scotland death certification data. Setting: General community. Participants: Children and young people with intellectual disabilities living in Scotland aged 5-24 years, and an age matched comparison group. Main outcome measures: Deaths up to 2020: age of death, age-standardised mortality ratios (age-SMRs); causes of death including cause-specific age-SMRs/sex-SMRs; and avoidable deaths. Results: Death occurred in 260/ 7,247 (3.6%) children/young people with intellectual disabilities (crude mortality rate=388/100,000 person years), and 528/156,439 (0.3%) children/young people without intellectual disabilities (crude mortality rate=36/100,000 person years). SMR for children/young people with, versus those without, intellectual disabilities were 10.7 for all causes (95% confidence interval (CI)=9.47-12.1), 5.17 for avoidable death (CI=4.19-6.37), 2.3 for preventable death (1.6-3.2), and 16.1 for treatable death (CI=12.5-20.8). SMRs were highest for children (27.4, CI=20.6-36.3) aged 5-9 years, and lowest for young people (6.6, CI=5.1-8.6) aged 20-24 years. SMRs were higher in more affluent neighbourhoods. Crude mortality incidences were higher for the children/young people with intellectual disabilities for most ICD-10 chapters. The most common underlying avoidable causes of mortality for children/young people with intellectual disabilities were epilepsy, aspiration/reflux/choking and respiratory infection, and for children/young people without intellectual disabilities, were suicide, accidental drug-related deaths and car accidents. Conclusion: Children with intellectual disabilities had significantly higher rates of all cause, avoidable, treatable, and preventable mortality than their peers. The largest differences were for treatable mortality, particularly at ages 5-9 years. Interventions to improve health-care to reduce treatable mortality should be a priority for children/young people with intellectual disabilities. Examples include improved epilepsy management and risk assessments, and co-ordinated multi-disciplinary actions to reduce aspiration/reflux/choking and respiratory infection. This is necessary across all neighbourhoods.

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Association of Intellectual Disability With All-Cause and Cause-Specific Mortality in Sweden

Abstract: This population-based cohort study evaluates the risks and prevalence of premature mortality in individuals with varying severity of intellectual disability in Sweden.

Cited by 47 publications

References 48 publications

Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption

Advanced Brain Imaging in Preterm Infants: A Narrative Review of Microstructural and Connectomic Disruption

Mortality rate and cause among people with intellectual disabilities in South Korea: A nationwide representative cross-sectional study from 2015 to 2019

Rates, causes and predictors of all-cause and avoidable mortality in 163,686 children and young people with and without intellectual disabilities: A record linkage national cohort study

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