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Prevalence and treatment of diabetes mellitus and hypertension among older adults with intellectual disability in comparison with the general population

Axmon, Anna LU ; Ahlström, Gerd LU and Höglund, Peter LU (2017) In BMC Geriatrics 17.
Abstract

BACKGROUND: Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID) have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups.

METHODS: This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936). We also established a same-sized referent cohort from the general... (More)

BACKGROUND: Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID) have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups.

METHODS: This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936). We also established a same-sized referent cohort from the general population matched by sex and year of birth. Information on diagnoses of diabetes mellitus and hypertension, and prescription of drugs for these disorders, were collected from national registers for the period 2006-2012. The two cohorts were compared using generalized linear models (GLM).

RESULTS: People with ID were 20% more likely than the general population to have a diagnosis of diabetes mellitus, and 26% more likely to have prescription of drugs for diabetes mellitus. People in the general population were 81% more likely to have a diagnosis of hypertension, and 9% more likely to have a prescription of drugs for hypertension. Among those with diabetes, ID was associated with higher occurrence of prescription of insulin combination drugs and sulfonylureas, but lower occurrence of prescription of dipeptidyl peptidase (DPP) 4-inhibitors and exenatide/liraglutide. Among those with hypertension, ID was associated with higher occurrence of prescription of diuretics, but lower occurrence of prescription of calcium channel blockers and angiotensin II antagonists.

CONCLUSIONS: Treatment regimens among people with ID tended to include older types of medication compared with what was prescribed in the general population. To ensure that this is medically appropriate and not due to failure to update the treatment regimen, it is important to investigate if the people with ID and diabetes mellitus or hypertension are subjected to the same regular drug reviews that are recommended for older adults in general.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Journal Article
in
BMC Geriatrics
volume
17
pages
12 pages
publisher
BioMed Central
external identifiers
  • scopus:85035791817
  • wos:000416051600002
ISSN
1471-2318
DOI
10.1186/s12877-017-0658-2
language
English
LU publication?
yes
id
1b0455ae-96a2-4310-bcd2-27b47b7290b2
date added to LUP
2017-12-04 08:25:14
date last changed
2018-01-16 13:26:54
@article{1b0455ae-96a2-4310-bcd2-27b47b7290b2,
  abstract     = {<p>BACKGROUND: Diabetes mellitus and hypertension are risk factors for cardiovascular disease, which is the most common cause of death in the world. People with intellectual disability (ID) have been reported to have high rates of both these disorders. The aim of this study was to describe and compare prevalence ratios of diabetes mellitus and hypertension between older adults with ID and their age peers in the general population, and to describe and compare treatment patterns in these two groups.</p><p>METHODS: This is a Swedish register-based study, in which we established a cohort of people aged 55+ years and who had received support for those with ID in 2012 (n = 7936). We also established a same-sized referent cohort from the general population matched by sex and year of birth. Information on diagnoses of diabetes mellitus and hypertension, and prescription of drugs for these disorders, were collected from national registers for the period 2006-2012. The two cohorts were compared using generalized linear models (GLM).</p><p>RESULTS: People with ID were 20% more likely than the general population to have a diagnosis of diabetes mellitus, and 26% more likely to have prescription of drugs for diabetes mellitus. People in the general population were 81% more likely to have a diagnosis of hypertension, and 9% more likely to have a prescription of drugs for hypertension. Among those with diabetes, ID was associated with higher occurrence of prescription of insulin combination drugs and sulfonylureas, but lower occurrence of prescription of dipeptidyl peptidase (DPP) 4-inhibitors and exenatide/liraglutide. Among those with hypertension, ID was associated with higher occurrence of prescription of diuretics, but lower occurrence of prescription of calcium channel blockers and angiotensin II antagonists.</p><p>CONCLUSIONS: Treatment regimens among people with ID tended to include older types of medication compared with what was prescribed in the general population. To ensure that this is medically appropriate and not due to failure to update the treatment regimen, it is important to investigate if the people with ID and diabetes mellitus or hypertension are subjected to the same regular drug reviews that are recommended for older adults in general.</p>},
  articleno    = {272},
  author       = {Axmon, Anna and Ahlström, Gerd and Höglund, Peter},
  issn         = {1471-2318},
  keyword      = {Journal Article},
  language     = {eng},
  month        = {11},
  pages        = {12},
  publisher    = {BioMed Central},
  series       = {BMC Geriatrics},
  title        = {Prevalence and treatment of diabetes mellitus and hypertension among older adults with intellectual disability in comparison with the general population},
  url          = {http://dx.doi.org/10.1186/s12877-017-0658-2},
  volume       = {17},
  year         = {2017},
}