Cause of death in adults with intellectual disability in the United States

Abstract

Background: Prior studies report that adults with intellectual disability (ID) have cause of death patterns distinct from adults in the general population but do not provide comparative analysis by specific causes of death.

Methods: Data are from the National Vital Statistics System 2005-2017 US Multiple Cause-of-Death Mortality files. We utilised adjusted odds ratios to identify causes of death that were more common for adults whose death certificate indicated ID (N = 22 512) than for adults whose death certificate did not indicate ID (N = 32 738 229), controlling for severity level of ID. We then examine the associations between biological sex and race-ethnicity and causes of death solely among adults with ID.

Results: The leading cause of death for adults with and without ID indicated on their death certificate was heart disease. Adults with ID, regardless of the severity of the disability, had substantially higher risk of death from pneumonitis, influenza/pneumonia and choking. Adults with mild/moderate ID also had higher risk of death from diabetes mellitus. Differences in cause of death trends were associated with biological sex and race-ethnicity.

Conclusions: Efforts to reduce premature mortality for adults with ID should attend to risk factors for causes of death typical in the general population such as heart disease and cancer, but also should be cognisant of increased risk of death from choking among all adults with ID, and diabetes among adults with mild/moderate ID. Further research is needed to better understand the factors determining comparatively lower rates of death from neoplasms and demographic differences in causes of death among adults with ID.

Keywords: age; biological sex; cause of death; intellectual disability; mortality; race-ethnicity.

Conflict of interest statement

Conflict of interest

No conflicts of interest have been declared.

© 2020 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Figures

Figure 1.

Adjusted odds ratios for specific causes of death between adults with and without intellectual disability by level of disability, 2005–2017 US Multiple Cause-of-Death Mortality file (N = 32 760 741).

Figure 2.

Predicted probabilities of top 3 causes of death by age for adults with and without mild/moderate intellectual disability, 2005–2017 US Multiple Cause of Death Mortality files (N = 32 738 850).

Figure 3.

Predicted probabilities of specific causes of death by age for adults with and without severe/profound intellectual disability, 2005–2017 US Multiple Cause of Death Mortality file (N = 32 741 994).

Figure 4.

Predicted probabilities of specific causes of death by age for adults with and without unspecified intellectual disability, 2005–2017 US Multiple Cause of Death Mortality file (N = 32 778 867).

Figure 5.

Adjusted odds ratios (AORs) for causes of death for female individuals compared with male individuals for adults intellectual disability, 2005–2017 US Multiple Cause-of-Death Mortality files (N = 22 512).

Figure 6.

Adjusted odds ratios (AORs) for causes of death for racial-ethnic minorities compared with Non-Hispanic Whites for adults with intellectual disability, 2005–2017 US Multiple Cause-of-Death Mortality (N = 22 512).