Management of eating, drinking, and/or swallowing challenges is needed

Marcus Redley, PhD
University of Cambridge, UK

Adults with intellectual disabilities (ID) experience a wide range of eating, drinking and/or swallowing (EDS) problems, for which they receive mealtime support interventions. Previous research has estimated that dysphagia (difficulty swallowing) affects 8% of all adults with ID and that 15% require some form of mealtime support. People with ID (whether they require mealtime support or not) also experience a greater burden of ill health and die younger than their peers in the general population with no ID.

What did you do in your research?
This study was conducted in two counties in the East of England. We set out to examine health related outcomes in adults with ID who receive mealtime support for any eating, drinking or swallowing (EDS) problems, by establishing the annual incidence of healthcare use, EDS-related ill health, and all-cause mortality. A total of 142 individuals with mild ID (and EDS difficulty) were involved in the study and 127 were involved in the follow-up study (8 had died and 7 could not be contacted).

What did you find out?
Approximately 85%-95% of study participants saw their general practitioner (GP) in the last year and 20% had one or more emergency hospitalizations. Although their annual number of GP visits was comparable with that of the general population, one-fifth of the participants with ID healthcare use was directly attributable to EDS-related ill health.

Respiratory infections were the most common cause of morbidity, and the immediate cause of eight deaths, while concerns about nutrition and dehydration were surprisingly minor. Our participants had a high annual incidence of death (5%) and their observed mortality was more than twice that expected in the general population of adults with ID (not selected because of mealtime support for EDS problems).

What are the take-home messages?
Improved management of EDS problems in adults with ID may have the potential to reduce the burden of respiratory infection and prevent hospital admissions and premature death. Therefore, all annual health checks now offered to adults with ID should include questions about respiratory infections and EDS functioning, in order to focus attention on EDS problems in this population.

To learn more about these findings contact Marcus Redley.

Full Journal Article
Perez, C. M., Ball, S. L., Wagner, A. P., Clare, I. C. H., Holland, A. J., & Redley, M. (2015). The incidence of healthcare use, ill health and mortality in adults with intellectual disabilities and mealtime support needs. Journal of Intellectual Disability Research, 59(7), 638–652.