چکیده (انگلیسی):

Background:Adults with intellectual disabilities have increased early mortality compared with the general population.
However, their extent of multimorbidity (two or more additional conditions) compared with the general population is
unknown, particularly with regards to physical ill-health, as are associations between comorbidities, neighbourhood
deprivation, and age.
Methods:We analysed primary health-care data on 1,424,378 adults registered with 314 representative Scottish
practices. Data on intellectual disabilities, 32 physical, and six mental health conditions were extracted. We generated
standardised prevalence rates by age-groups, gender, and neighbourhood deprivation, then calculated odds ratio (OR)
and 95 % confidence intervals (95 % CI) for adults with intellectual disabilities compared to those without, for the
prevalence, and number of condition.
Results:Eight thousand fourteen (0.56 %) had intellectual disabilities, of whom only 31.8 % had no other conditions
compared to 51.6 % without intellectual disabilities (OR 0.26, 95 % 0.25–0.27). The intellectual disabilities group were
significantly more likely to have more conditions, with the biggest difference found for three conditions (10.9 % versus
6.8 %; OR 2.28, 95 % CI 2.10–2.46). Fourteen physical conditions were significantly more prevalent, and four
cardiovascular conditions occurred less frequently, as did any cancers, and chronic obstructive pulmonary diseases. Five
of the six mental health conditions were significantly more prevalent. For the adults with intellectual disabilities, no
gradient was seen in extent of multimorbidity with increasing neighbourhood deprivation; indeed findings were
similar in the most affluent and most deprived areas. Co-morbidity increased with age but is highly prevalent at all
ages, being similar at age 20–25 to 50–54 year olds in the general population.
Conclusions:Multi-morbidity burden is greater, occurs at much earlier age, and the profile of health
conditions differs, for adults with intellectual disabilities compared with the general population. There is no association
with neighbourhood deprivation; people with intellectual disabilities need focussed services irrespective of where they
live, and at a much earlier age than the general population. They require specific initiatives to reduce inequalities.