Increased Longevity and the comorbidities associated with intellectual and developmental disability

Abstract

The health and survival of people with intellectual and developmental disabilities (IDD) have increased significantly during the past century, aided by deinstitutionalisation and improved access to health care. In high-income countries, life expectancy estimates are now approximately 70 years for people with mild IDD and 60 years for those with more severe levels of IDD. The increasing survival of people with IDD will result in a greater risk of age-related morbidity, and both adult-onset cancers and non-malignant disorders, especially since age-related comorbidities generally appear at younger ages than in the general population in disorders such as Down syndrome, a ‘whole of life’ approach to health care is required, with greater focus especially needed during the period spanning middle age to senescence so that appropriate management regimes can be implemented on an individual and disorder-specific basis. Secondary conditions that arise later in adulthood, including osteoporosis, obesity, cardiovascular disease, epilepsy and dementia, additionally need to be considered within health care plans. The types of interventions offered and continuity of care are of critical importance, especially since people with IDD, including those with Down syndrome, will frequently outlive their parents and even their siblings