Cardiovascular Disease Incidence and Risk Factors in Older Adults With Intellectual Disabilities: Results of the Healthy Ageing and Intellectual Disabilities Study

ABSTRACT Background Previous research has shown that older adults with intellectual disabilities are at increased risk of cardiovascular diseases (CVD). However, longitudinal studies investigating the actual incidence of CVD and its associated risk factors in this population are limited. Such resear...

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Published in:Journal of intellectual disability research Vol. 69; no. 11; pp. 1261 - 1271
Main Authors: Leeuw, Marleen J., Böhmer, Mylène N., Bindels, Patrick J. E., Maes‐Festen, Dederieke A. M., Oppewal, Alyt
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01.11.2025
Subjects:
Adults
Aged
Aging
Aging (Individuals)
antipsychotic agents
Antipsychotics
blood pressure
cardiac failure
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
cerebrovascular accident
Comorbidity
Competing risks models
Disability studies
Disease
Disease Incidence
Down syndrome
Female
follow‐up studies
Health care delivery
Health services
Heart failure
Heart Failure - epidemiology
Humans
Hypertension
Incidence
Intellectual disabilities
Intellectual Disability
Intellectual Disability - epidemiology
Longitudinal Studies
Male
Medical records
Middle Aged
Myocardial infarction
Myocardial Infarction - epidemiology
occurrence
Older people
Participant Characteristics
People with disabilities
Prospective Studies
Psychotropic drugs
Resource allocation
Risk assessment
Risk Factors
Risk management
Stroke
Stroke - epidemiology
blood pressure
prospective studies
aged
follow‐up studies
occurrence
antipsychotic agents
cerebrovascular accident
intellectual disability
cardiac failure
longitudinal studies
ISSN:0964-2633, 1365-2788, 1365-2788
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Summary:ABSTRACT Background Previous research has shown that older adults with intellectual disabilities are at increased risk of cardiovascular diseases (CVD). However, longitudinal studies investigating the actual incidence of CVD and its associated risk factors in this population are limited. Such research is essential for optimising healthcare delivery and informing effective resource allocation. Therefore, this study aimed to examine CVD incidence in older adults with intellectual disabilities and explore its associations with participant characteristics and risk factors. Method A prospective longitudinal study was conducted in older adults (≥ 50 years) with intellectual disabilities as part of the Healthy Ageing and Intellectual Disabilities study. Baseline measurements were performed in 2009–2010, with follow‐up assessments, including medical record reviews, in 2020–2023. Incidence rates for myocardial infarction (MI), heart failure (HF) and stroke were calculated by sex and 10‐year age categories. Competing risk analysis was performed to examine the associations between CVD diagnoses during follow‐up and baseline participant characteristics/CVD risk factors, accounting for mortality as a competing risk. Results Among 598 participants (62.0 ± 8.5 year; 49.3% female), with a mean follow‐up of 8.6 years, incidence rates were 2.3 per 1000 person years for MI, 7.2 for HF, and 5.3 for stroke. Hypertension (HR 3.17; p < 0.001), Down syndrome (HR 2.66; p < 0.01) and antipsychotic use (HR 1.98; p = 0.04) were associated with an increased CVD risk during follow‐up. Conclusions A lower incidence of MI and similar to higher incidence of HF and stroke were found in older adults with intellectual disabilities than in the general population. Further research, including a focus on the association of CVD incidence with Down syndrome, is needed. Meanwhile, proactive assessment and management of CVD risk factors, such as hypertension and antipsychotic use, are important for improving cardiovascular health in older adults with intellectual disabilities.
Bibliography:Funding
This work was supported by Amarant, Ipse de Bruggen, Department of General Practice, Intellectual Disability Medicine Research, Erasmus MC, University Medical Center Rotterdam, Abrona. The three care organisations were not involved in the conduct of data processing, analysis and preparation of the manuscript.
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ISSN:0964-2633
1365-2788
1365-2788
DOI:10.1111/jir.70004