Health Needs and Their Relationship with Life Expectancy in People with and without Intellectual Disabilities in England

Freya Tyrer; Richard Morriss; Reza Kiani; Satheesh K Gangadharan; Harish Kundaje; Mark J Rutherford

doi:10.3390/ijerph19116602

Health Needs and Their Relationship with Life Expectancy in People with and without Intellectual Disabilities in England

Int J Environ Res Public Health. 2022 May 28;19(11):6602. doi: 10.3390/ijerph19116602.

Authors

Freya Tyrer¹, Richard Morriss², Reza Kiani^{3

4}, Satheesh K Gangadharan^{3

4}, Harish Kundaje⁵, Mark J Rutherford¹

Affiliations

¹ Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK.
² Institute of Mental Health, University of Nottingham, Nottingham NG7 2TU, UK.
³ Leicestershire Learning Disability Services (Psychiatry), Leicestershire Partnership NHS Trust, Leicester LE4 8PQ, UK.
⁴ Mental Health, Ageing, Public Health and Primary Care Research Group, Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK.
⁵ Lakeside Healthcare, Cottingham Road, Corby NN17 2UR, UK.

Abstract

Health needs are common in people living with intellectual disabilities, but we do not know how they contribute to life expectancy. We used the Clinical Practice Research Datalink (CPRD) linked with hospital/mortality data in England (2017-2019) to explore life expectancy among people with or without intellectual disabilities, indicated by the presence or absence, respectively, of: epilepsy; incontinence; severe visual loss; severe visual impairment; severe mobility difficulties; cerebral palsy and PEG feeding. Life expectancy and 95% confidence intervals were compared using flexible parametric methods. At baseline, 46.4% (total n = 7794) of individuals with intellectual disabilities compared with 9.7% (total n = 176,807) in the comparison group had ≥1 health need. Epilepsy was the most common health need (18.7% vs. 1.1%). All health needs except hearing impairment were associated with shorter life expectancy: PEG feeding and mobility difficulties were associated with the greatest loss in life years (65-68% and 41-44%, respectively). Differential life expectancy attenuated but remained (≈12% life years lost) even after restricting the population to those without health needs (additional years expected to live at 10 years: 65.5 [60.3, 71.1] vs. 74.3 [73.8, 74.7]). We conclude that health needs play a significant role but do not explain all of the differential life expectancy experienced by people with intellectual disabilities.

Keywords: PEG feeding; cerebral palsy; epilepsy; health needs; hearing; incontinence; intellectual disability; life expectancy; mobility; visual.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Disabled Persons*
England / epidemiology
Epilepsy* / epidemiology
Humans
Intellectual Disability* / epidemiology
Life Expectancy

Grants and funding

This research was funded from a Baily Thomas Doctoral Fellowship award (TRUST/VC/AC/SG/5366-8393). The funders had no role in study design, data collection and analysis, the decision to publish or the preparation of the manuscript. The study is based in part on data from the CPRD GOLD database obtained under licence from the UK Medicines and Healthcare products Regulatory Agency. The provision of CPRD and linked data was through Leicester Real World Evidence (LRWE) Unit, which is funded by University of Leicester, National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East Midlands and Leicester NIHR Biomedical Research Centre. The interpretation and conclusions contained in this article are those of the authors alone and not necessarily those of the LRWE Unit, the NHS, the NIHR or the Department of Health and Social Care.