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Querido A, Costa MJ, Araújo D, Sampaio AR, Vilas-Boas JP, Corredeira R, Daly DJ, Fernandes RJ. Swimmers with Down Syndrome Are Healthier and Physically Fit than Their Untrained Peers. Healthcare (Basel) 2023; 11:healthcare11040482. [PMID: 36833016 PMCID: PMC9956035 DOI: 10.3390/healthcare11040482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023] Open
Abstract
While there are positive benefits from physical activity participation for individuals with Down syndrome, little is known about the effects of swimming training. The aim of this study was to compare the body composition and physical fitness profile of competitive swimmers and moderately active (untrained) individuals with Down syndrome. The Eurofit Special test was applied to a group of competitive swimmers (n = 18) and a group of untrained individuals (n = 19), all with Down syndrome. In addition, measurements were taken to determine body composition characteristics. The results showed differences between swimmers and untrained subjects in height, sum of the four skinfolds, body fat %, fat mass index and all items of the Eurofit Special test. Swimmers with Down syndrome exhibited physical fitness levels near to the Eurofit standards, although lower fitness levels were attained by these persons when compared to athletes with intellectual disability. It can be concluded that the practice of competitive swimming seems to counteract the tendency for obesity in persons with Down syndrome and also helps to increase strength, speed and balance.
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Affiliation(s)
- Ana Querido
- N2i, Polytechnic Institute of Maia, 4475-690 Maia, Portugal
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, LABIOMEP-UP, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Correspondence:
| | - Mário J. Costa
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, LABIOMEP-UP, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Dália Araújo
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, LABIOMEP-UP, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - António R. Sampaio
- N2i, Polytechnic Institute of Maia, 4475-690 Maia, Portugal
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, LABIOMEP-UP, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - João P. Vilas-Boas
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, LABIOMEP-UP, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Rui Corredeira
- Research Centre in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Daniel J. Daly
- Faculty of Movement and Rehabilitation Sciences, Katholiek Universiteit Leuven, 3001 Leuven, Belgium
| | - Ricardo J. Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, LABIOMEP-UP, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
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Vancampfort D, Van Damme T, Firth J, Stubbs B, Schuch F, Suetani S, Arkesteyn A, Van Biesen D. Physical activity correlates in children and adolescents, adults, and older adults with an intellectual disability: a systematic review. Disabil Rehabil 2021; 44:4189-4200. [PMID: 33861676 DOI: 10.1080/09638288.2021.1909665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Understanding enablers of and barriers for physical activity (PA) participation in people with intellectual disability (ID) is an essential first step to develop effective interventions. This systematic review examined correlates of PA across the socio-ecological model (i.e., intra-personal, inter-personal, environmental and policy level) in people with ID across the lifespan. MATERIAL AND METHODS Major electronic databases were searched from inception until 15 February 2021. Keywords included "physical activity" or "exercise" and "intellectual disability" or "mental retardation." A summary coding was used to analyze the data for adolescents (<18 years), adults (18 < 50 years), and older adults (50≤ years). RESULTS Out of 83 PA correlates, retrieved from 39 studies (n = 26,456), only three consistent (i.e., reported in four or more studies) correlates were identified. In adults, older age (7/11, 64%), more severe ID (9/9, 100%) and the presence of physical mobility problems (3/4, 75%) were associated with decreased PA. From 38 correlates identified, no consistent correlates were identified for children and adolescents and older people. CONCLUSIONS Despite the abundance of evidence of the PA benefits for people with ID, we only found consistent evidence for three correlates reliably being related to PA in adults with ID. More research, particularly among young and older people is urgently needed.IMPLICATIONS FOR REHABILITATIONMore severe intellectual disability is an important barrier for being active in adults with intellectual disability.Presence of physical health problems is an important barrier for being active in adults with intellectual disability.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK.,NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, Wacol, Australia.,Queensland Brain Institute, The University of Queensland, St Lucia, Australia.,School of Medicine, Griffith University, Nathan, Australia
| | - Anke Arkesteyn
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Westrop SC, Melville CA, Muirhead F, McGarty AM. Gender differences in physical activity and sedentary behaviour in adults with intellectual disabilities: A systematic review and meta-analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1359-1374. [PMID: 31373127 DOI: 10.1111/jar.12648] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/09/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Adults with intellectual disabilities are reported to be highly inactive, with research required to understand contributory factors. This systematic review aimed to investigate gender differences in physical activity (PA) and sedentary behaviour (SB) in adults with intellectual disabilities. METHODS This systematic review was reported in accordance with PRISMA guidelines. Seven databases were searched up to, and including, January 2018. Screening identified papers that assessed gender-specific PA and/or SB outcomes in adults with intellectual disabilities. Data were synthesized using a narrative synthesis and random effects model meta-analyses. RESULTS Twenty-six papers were included; 25 measured PA, and eight assessed SB. Women with intellectual disabilities were least active with a significant overall effect of gender identified. For SB, no consistent gender differences were found. CONCLUSIONS Reflecting the general population, men with intellectual disabilities were most active. Intellectual disability research should consider the role of gender to inform future interventions targeting inactivity.
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Affiliation(s)
- Sophie C Westrop
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Craig A Melville
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fiona Muirhead
- Physical Activity and Health Research Group, University of Strathclyde, Glasgow, UK
| | - Arlene M McGarty
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Marks B, Sisirak J, Magallanes R, Krok K, Donohue-Chase D. Effectiveness of a HealthMessages Peer-to-Peer Program for People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:242-258. [PMID: 31120402 PMCID: PMC8118146 DOI: 10.1352/1934-9556-57.3.242] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Effective strategies to improve health education, food choices, and physical activity are vital for people with intellectual and developmental disabilities (IDD), as their sedentary lifestyles and high fat diets are contributing to poor health, such as cardiovascular disease, osteoporosis, hypertension, Type II diabetes, and obesity. This study examined the effectiveness of a peer-led health promotion program for people with IDD. One group pre/post-test design was used to test the feasibility and effectiveness of the 12-week HealthMessages Program for three groups: peer health coaches (PHCs), mentors, and peer participants. A total of 379 volunteers participated including PHCs people with IDD (n = 33), mentors-staff from community organizations (n = 35), and peer participants-peers with IDD (n = 311). Following the intervention and 12-week HealthMessages Program, PHCs had significant changes in physical activity and hydration knowledge, mentors had significant changes in self-efficacy scores, and peer participants had significant changes in physical activity and hydration knowledge, social supports, and total health behaviors. A dyad approach supported PHCs and mentors to implement a successful HealthMessages Program with their peers.
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Affiliation(s)
- Beth Marks
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Jasmina Sisirak
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Rubia Magallanes
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Kristin Krok
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Dina Donohue-Chase
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
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Alwhaibi RM, Aldugahishem HM. Factors affecting participation in physical activities in Saudi children with Down syndrome: mothers' perspectives. Disabil Rehabil 2018; 41:1524-1535. [PMID: 29382238 DOI: 10.1080/09638288.2018.1433241] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Physical activity provides a wide range of benefits. Several studies conducted in various countries have examined factors influencing participation in physical activities in children with Down syndrome. This study aimed to explore factors affecting participation in physical activities in Saudi children with DS, from their mothers' perspectives. MATERIALS AND METHODS In-depth interviews were conducted with 36 mothers of children with Down syndrome to explore facilitators of and barriers to their children's participation in physical activities. All audio recordings were transcribed, validated, reviewed by the authors independently, and organized into themes. RESULTS Transcript analysis resulted in four facilitators (mother's support and siblings' involvement, involvement of peers, type of physical activity experience, and child's physical ability, behavioral, and psychological status), and six barriers (conditions associated with Down syndrome, family responsibility, social barriers, environmental constraints, electronic devices, and mother's personal psychological barriers). CONCLUSIONS The results regarding perceived barriers indicated a need to develop and implement programs involving family consultation. Environmental modifications should be made to accommodate the needs of children with Down syndrome. A well-organized partnership should be established and activated between private investors and the Ministries of Education, Social Affairs, and Health, to support the promotion of physical activity. Implications for rehabilitation The efficacy of home- and Internet-based programs for Saudi children with Down syndrome (DS) should be evaluated. Cultural and climactic conditions in Saudi Arabia suggest the need for environmental modifications to help children with DS engage in physical activity. Well-organized partnerships between private investors and the Ministries of Education, Social Affairs, and Health may be required to achieve higher participation of children with DS. Planning and designing of strategies, policies, facilities, and programs are required to increase engagement in physical activity and maximize the benefits of participation of children with DS.
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Affiliation(s)
- Reem M Alwhaibi
- a Rehabilitation Department , College of Health and Rehabilitation Sciences, Princess Nourah University , Riyadh , Saudi Arabia
| | - Hayfa M Aldugahishem
- a Rehabilitation Department , College of Health and Rehabilitation Sciences, Princess Nourah University , Riyadh , Saudi Arabia
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Feasibility of Assessing Diet with a Mobile Food Record for Adolescents and Young Adults with Down Syndrome. Nutrients 2017; 9:nu9030273. [PMID: 28335382 PMCID: PMC5372936 DOI: 10.3390/nu9030273] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/09/2017] [Indexed: 11/19/2022] Open
Abstract
Technology-based methods for assessing diet in those with disability remains largely unexplored. The aim was to assess the feasibility of assessing diet with an image-based mobile food record application (mFR) in 51 adolescents and young adults with Down syndrome (PANDs). Adherence was also assessed with the instruction to include a fiducial marker object in the before and after eating images. The PANDs sample completed a four-day mFR and results were compared with a sample of young adults from the Connecting Health and Technology study (CHAT, n = 244). Compared to the CHAT sample, PANDs participants reported more fruit (2.2 ± 1.8 versus 1.0 ± 0.9 serves respectively) and vegetables (2.4 ± 1.3 versus 1.9 ± 1.0 serves, respectively), but no differences in energy-dense nutrient-poor (EDNP) foods and beverages were observed. Compared to CHAT, PANDs participants captured fewer images with the mFR (4.9 ± 2.3 versus 4.0 ± 1.5 images, respectively). Adherence to the instruction to include the fiducial marker in images was lower for PANDs compared with the CHAT sample (90.3% versus 96.5%). Due to the quality of information captured in images and the high acceptability of the fiducial marker, the mFR shows great promise as a feasible method of assessing diet in adolescents and young adults with Down syndrome.
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Jurkowski JM, Rivera Y, Hammel J. Health Perceptions of Latinos With Intellectual Disabilities: The Results of a Qualitative Pilot Study. Health Promot Pract 2016; 10:144-55. [DOI: 10.1177/1524839907309045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A pilot study among Latinos with intellectual disabilities (ID) was conducted. Focus groups and Photovoice methodology were employed to explore participants' health perceptions and beliefs. Three focus groups were conducted for a total of 15 participants. An additional member check focus group was conducted to verify results of the analysis. Photovoice methodology was employed with four Latinos with ID to explore health beliefs and perceptions of the influence of the social and physical environment. Participants' perceptions of health focused on social and mental aspects of health. Latinos with ID believed that social relationships are important to health. They believed in a connection among social, mental, and physical well-being and health. Cultural beliefs related to the role of God and traditional therapies were identified. Latinos with ID reported that they believed that health was influenced by behaviors and that diet and physical activity were beneficial, but this did not necessarily translate into regular practice.
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Affiliation(s)
- Janine M. Jurkowski
- Department of Health Policy, Management & Behavior at the University at Albany School of Public Health in Rensselaer, New York
| | | | - Joy Hammel
- Departments of Occupational Therapy and Disability and
Human Development, Joint Doctoral Program in Disability Studies, University
of Illinois at Chicago in Chicago, Illinois
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MacDonald M, Leichtman J, Esposito P, Cook N, Ulrich DA. The Participation Patterns of Youth with Down Syndrome. Front Public Health 2016; 4:253. [PMID: 27891498 PMCID: PMC5104961 DOI: 10.3389/fpubh.2016.00253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 10/27/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this paper was to investigate the participation patterns of children with Down syndrome (DS) using the construct of participation as defined by the International Classification of Functioning Disability and Health (ICF). METHODS Sixty-two children with DS were recruited between the ages of 9 and 17 years. All participants were given an interview-administered version of the Children's Assessment of Participation and Enjoyment (CAPE) to measure participation (1). RESULTS Children with DS participated the most often, based on frequency, in recreational activities (p < 0.001); social activity types represented the greatest extension into the community based on with whom the children participated with (p < 0.05); finally, physical and social activities represented the greatest extension into the community geographically (p < 0.001). In addition, children with DS are significantly more active in activities that are informal in nature. CONCLUSION Children with DS participate in a number of activities; however, the extent of their participation within these activities differs depending on the participation pattern examined. Implications for educational and community-based programs are discussed.
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Affiliation(s)
- Megan MacDonald
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | | | - Phil Esposito
- College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, USA
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Convertini P, Menga A, Andria G, Scala I, Santarsiero A, Castiglione Morelli MA, Iacobazzi V, Infantino V. The contribution of the citrate pathway to oxidative stress in Down syndrome. Immunology 2016; 149:423-431. [PMID: 27502741 DOI: 10.1111/imm.12659] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 06/25/2016] [Accepted: 07/29/2016] [Indexed: 12/13/2022] Open
Abstract
Inflammatory conditions and oxidative stress have a crucial role in Down syndrome (DS). Emerging studies have also reported an altered lipid profile in the early stages of DS. Our previous works demonstrate that citrate pathway activation is required for oxygen radical production during inflammation. Here, we find up-regulation of the citrate pathway and down-regulation of carnitine/acylcarnitine carrier and carnitine palmitoyl-transferase 1 genes in cells from children with DS. Interestingly, when the citrate pathway is inhibited, we observe a reduction in oxygen radicals as well as in lipid peroxidation levels. Our preliminary findings provide evidence for a citrate pathway dysregulation, which could be related to some phenotypic traits of people with DS.
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Affiliation(s)
| | - Alessio Menga
- Department of Biosciences, Biotechnology and Pharmacological Sciences, University of Bari, Bari, Italy
| | - Generoso Andria
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Napoli, Italy
| | - Iris Scala
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University, Napoli, Italy
| | | | | | - Vito Iacobazzi
- Department of Biosciences, Biotechnology and Pharmacological Sciences, University of Bari, Bari, Italy.
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Pucci F, Machado G, Solera E, Cenovicz F, Arruda C, Braga C, Nisihara R. Blood pressure levels and body mass index in Brazilian adults with Down syndrome. SAO PAULO MED J 2016; 134:330-4. [PMID: 27557142 PMCID: PMC10876337 DOI: 10.1590/1516-3180.2016.0057180316] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 03/18/2016] [Indexed: 12/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Increased life expectancy among people with Down syndrome (DS) has introduced new environmental factors that may affect blood pressure (BP) and/or lead to obesity in this population. The aim here was to investigate BP levels and body mass index (BMI) in adults with DS, correlating these data with the patients' sex and age. DESIGN AND SETTING Analytical cross-sectional observational study conducted in special schools in Curitiba (PR), Brazil. METHODS 97 adult patients were included. BP was measured in accordance with the established guidelines. BMI was calculated by dividing the weight by the height squared (kg/m2). RESULTS Sex had no influence on BMI; nor did systolic BP (SBP) or diastolic BP (DBP). The age range was from 18 to 56 years. No correlation was observed between increasing age and greater BMI or BP. Eighty-six individuals (88.7%) presented normal BP, eleven (11.3%) prehypertension and none hypertension. Twenty patients (20.4%) presented BP lower than 90 × 60 mmHg. BMI ranged from 18 to 48 kg/m2 (mean of 28.8 ± 3.92 kg/m2): 21.9% had normal weight; 40.7% were overweight; and 25.3% had obesity class I, 9.9% class II and 2.2% class III. Higher BMI was associated with significantly greater SBP and DBP (P = 0.0175 and P = 0.0015). CONCLUSION Sex and age did not influence SBP, DBP or BMI in Brazilian adults with DS. Higher BMI was associated with greater BP (both systolic and diastolic).
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Affiliation(s)
- Felipe Pucci
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Guilherme Machado
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Edcarlo Solera
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Fernanda Cenovicz
- Undergraduate Student, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Christian Arruda
- MD. Attending Physician, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Chiu Braga
- PhD, Assistant Professor, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
| | - Renato Nisihara
- PhD, Assistant Professor, Department of Medicine, Universidade Positivo (UP), Curitiba, PR, Brazil.
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Hsieh K, Heller T, Bershadsky J, Taub S. Impact of adulthood stage and social-environmental context on body mass index and physical activity of individuals with intellectual disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 53:100-113. [PMID: 25860448 DOI: 10.1352/1934-9556-53.2.100] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Individuals with intellectual disability (ID) are at risk for obesity and physical inactivity. We analyzed a subset of 2009-2010 National Core Indicators (NCI) database to examine (1) the impact of three adulthood stages- younger (20-39 years), middle (40-59 years), and older (60 years and older) on Body Mass Index (BMI) and physical activity (PA); and (2) the relationship between social-environmental context (i.e., residence type, everyday choices, and community participation) and BMI and PA, with adjustment for individual characteristics of the adults with ID. Findings highlight the need to pay more attention to obesity by providing health education and emphasizing healthy choices. Results also suggest the importance of community participation as a way of promoting more physical activity.
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13
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Real de Asua D, Parra P, Costa R, Moldenhauer F, Suarez C. A cross-sectional study of the phenotypes of obesity and insulin resistance in adults with down syndrome. Diabetes Metab J 2014; 38:464-71. [PMID: 25541610 PMCID: PMC4273033 DOI: 10.4093/dmj.2014.38.6.464] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/17/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite the confluence of multiple cardiovascular risk factors, subclinical atherosclerotic damage and cardiovascular events remain extremely rare in adults with Down syndrome (DS). We aim to determine the prevalence of obesity and metabolic disorders in an adult cohort with DS and to compare our findings with adults without DS. METHODS Cross-sectional study of 51 consecutively selected adults with DS living in the community and 51 healthy controls in an outpatient clinic of a tertiary care hospital in Madrid, Spain. Epidemiological data (age and gender), anthropometric data (body mass index and waist-to-height ratio), coexisting clinical conditions, and laboratory data (fasting glucose, insulin, glycated hemoglobin, creatinine, thyroid hormones, vitamins, and lipid profile) were measured and compared between the groups. RESULTS Adults with DS were significantly younger and more often men with a higher prevalence of overweight and obesity than controls. Their waist-to-height ratio was higher, and they more frequently had abdominal obesity. The results of an analysis adjusted for age and gender revealed no differences in fasting insulin levels, homeostatic model assessment indexes, or lipid profile between adults with DS and controls. CONCLUSION Adults with DS presented a high prevalence of overweight and obesity. However, we found no differences in lipid profile, prevalence of insulin resistance, or metabolic syndrome between adults with DS and controls.
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Affiliation(s)
- Diego Real de Asua
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, Madrid, Spain
| | - Pedro Parra
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, Madrid, Spain
| | - Ramón Costa
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, Madrid, Spain
| | - Fernando Moldenhauer
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, Madrid, Spain
| | - Carmen Suarez
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, Madrid, Spain
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Real de Asua D, Parra P, Costa R, Moldenhauer F, Suarez C. Evaluation of the impact of abdominal obesity on glucose and lipid metabolism disorders in adults with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2942-2949. [PMID: 25108610 DOI: 10.1016/j.ridd.2014.07.038] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/15/2014] [Accepted: 07/15/2014] [Indexed: 06/03/2023]
Abstract
We aimed to describe anthropometric differences in weight-related disorders between adults with Down syndrome (DS) and healthy controls, as well as their disparate impact on glucose and lipid metabolism disorders. We underwent a cross-sectional study of 49 consecutively selected, community-residing adults with DS and 49 healthy controls in an outpatient clinic of a tertiary care hospital in Madrid, Spain. Siblings of adults with DS were studied as controls in 42 cases. Epidemiological data (age and gender), anthropometric data (body mass index, waist circumference, and waist-to-height ratio [WHR]), coexisting clinical conditions, and laboratory data (fasting glucose, insulin, glycated hemoglobin, creatinine, thyroid hormones, and lipid profile) were measured and compared between the groups. Adults with DS were significantly younger and more often male, with a higher prevalence of overweight and obesity than controls. Adults with DS also had a higher WHR, and more frequently presented abdominal obesity. Moreover, insulin resistance measured using the homeostatic model assessment was more prevalent among adults with DS and abdominal obesity. However, lipid profiles were similar between groups. The kappa correlation index for the diagnosis of abdominal obesity between waist circumference and WHR was 0.24 (95%CI: 0.13-0.34). We concluded that the prevalence of overweight, obesity, and abdominal obesity was higher in adults with DS than in controls. Adults with DS and abdominal obesity showed higher indexes of insulin resistance than their non-obese peers. WHR was a useful tool for the evaluation of abdominal obesity in this population.
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Affiliation(s)
- Diego Real de Asua
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, C/Diego de León 62, 28006 Madrid, Spain.
| | - Pedro Parra
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, C/Diego de León 62, 28006 Madrid, Spain.
| | - Ramón Costa
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, C/Diego de León 62, 28006 Madrid, Spain.
| | - Fernando Moldenhauer
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, C/Diego de León 62, 28006 Madrid, Spain.
| | - Carmen Suarez
- Adult Down Syndrome Outpatient Clinic, Department of Internal Medicine, Fundación de Investigación Biomédica, Hospital Universitario de La Princesa, C/Diego de León 62, 28006 Madrid, Spain.
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Johnson M, Yun J, McCubbin JA. Validity evidence for self-report with assistance to measure physical activity behavior in adults with intellectual disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 52:273-281. [PMID: 25061771 DOI: 10.1352/1934-9556-52.4.273] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Self-reported physical activity (PA) behavior with assistance from a secondary source has previously been used with adults with an intellectual disability (ID). Limited evidence of reliability and validity have been provided for this approach. This study examined evidence of convergent (CV) and discriminant (DV) validity for self-report with assistance from a secondary source as a measure of PA in adults with ID. PA of 37 participants with ID were assessed using (a) self-report, (b) accelerometers, and (c) pedometers. The multitrait-multimethod (MTMM) analysis was used to evaluate validity. MTMM analysis revealed high reliability among variables, low to strong CV, and moderate DV. The study outcomes provide initial convergent and discriminant validity evidence for this measure of PA in adults with ID.
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Pikora TJ, Bourke J, Bathgate K, Foley KR, Lennox N, Leonard H. Health conditions and their impact among adolescents and young adults with Down syndrome. PLoS One 2014; 9:e96868. [PMID: 24818963 PMCID: PMC4018436 DOI: 10.1371/journal.pone.0096868] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/12/2014] [Indexed: 11/18/2022] Open
Abstract
Objective To examine the prevalence of medical conditions and use of health services among young adults with Down syndrome and describe the impact of these conditions upon their lives. Methods Using questionnaire data collected in 2011 from parents of young adults with Down syndrome we investigated the medical conditions experienced by their children in the previous 12 months. Univariate, linear and logistic regression analyses were performed. Results We found that in addition to the conditions commonly experienced by children with Down syndrome, including eye and vision problems (affecting 73%), ear and hearing problems (affecting 45%), cardiac (affecting 25%) and respiratory problems (affecting 36%), conditions also found to be prevalent within our young adult cohort included musculoskeletal conditions (affecting 61%), body weight (affecting 57%), skin (affecting 56%) and mental health (affecting 32%) conditions and among young women menstrual conditions (affecting 58%). Few parents reported that these conditions had no impact, with common impacts related to restrictions in opportunities to participate in employment and community leisure activities for the young people, as well as safety concerns. Conclusion There is the need to monitor, screen and provide appropriate strategies such as through the promotion of healthy lifestyles to prevent the development of comorbidities in young people with Down syndrome and, where present, to reduce their impact.
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Affiliation(s)
- Terri J. Pikora
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Jenny Bourke
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Katherine Bathgate
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Kitty-Rose Foley
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Nicholas Lennox
- Queeensland Centre for Intellectual and Developmental Disability, University of Queensland, South Brisbane, Queensland, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
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Carmeli E, Coleman R. The Clinical Characteristics of Aging Adults with Mental Retardation. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/ptr.2001.6.4.267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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18
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Pett M, Clark L, Eldredge A, Cardell B, Jordan K, Chambless C, Burley J. Effecting healthy lifestyle changes in overweight and obese young adults with intellectual disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2013; 118:224-243. [PMID: 23734617 DOI: 10.1352/1944-7558-118.3.224] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We evaluated a 12-week recreation center-based healthy lifestyle intervention for 30 obese home-dwelling young adults (YA) with intellectual disabilities. Three cohorts participated: YA only, YA and parents, and parents only. The YA cohorts received a nutrition/exercise intervention; parents focused on modeling healthy lifestyle behaviors. Outcomes included YA blood, nutrition, anthropometric, and fitness measures at pre, post, and 3-month follow-up. Compared with wait-list controls, the YA-only cohort improved immediately postintervention in blood pressure (BP), weight, and balance (p < .05). At 3-month follow-up, no intervention was consistently superior; overall reductions in weight, BP, hip circumference, and exercise barriers were obtained (p < .05). Linear and curvilinear changes from baseline to 3 months after the intervention varied by outcome and participant. Participants with Down syndrome lost less weight.
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Affiliation(s)
- Marjorie Pett
- University of Utah, College of Nursing, Salt Lake City, UT, USA.
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Marks B, Sisirak J, Chang YC. Efficacy of the HealthMatters Program
Train-the-Trainer Model. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 26:319-34. [DOI: 10.1111/jar.12045] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Beth Marks
- Rehabilitation Research and Training Center on Aging with Developmental Disabilities; Department of Disability and Human Development; College of Applied Health Sciences; University of Illinois at Chicago; Chicago IL USA
| | - Jasmina Sisirak
- Rehabilitation Research and Training Center on Aging with Developmental Disabilities; Department of Disability and Human Development; College of Applied Health Sciences; University of Illinois at Chicago; Chicago IL USA
| | - Yen-Ching Chang
- Department of Healthcare Administration; I-Shou University; Kaohsiung Taiwan
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Wuang YP, Ho GS, Su CY. Occupational therapy home program for children with intellectual disabilities: a randomized, controlled trial. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:528-537. [PMID: 23085502 DOI: 10.1016/j.ridd.2012.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 09/11/2012] [Indexed: 06/01/2023]
Abstract
This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, and The Children's Assessment of Participation and Enjoyment scores at 10 and 20 weeks. The 20-week OTHP produced significant difference in fine motor function, activity participation, and parent satisfaction with performance, compared to those of no OTHP. Pediatricians can advise families to implement 20 weeks of OTHP with an average 15 min per session to facilitate functional changes of children with ID.
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Affiliation(s)
- Yee-Pay Wuang
- Department of Occupational Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan
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Caton S, Chadwick D, Chapman M, Turnbull S, Mitchell D, Stansfield J. Healthy lifestyles for adults with intellectual disability: knowledge, barriers, and facilitators. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2012; 37:248-259. [PMID: 22852820 DOI: 10.3109/13668250.2012.703645] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are more likely to have health problems than people without disability. Little previous research has investigated health from the perspective of the people with ID themselves. We aimed to focus on what people with ID understand being healthy to mean and what their experiences are of healthy lifestyles. METHOD Semistructured interviews were conducted with 13 adults with ID to ask them about their health and healthy lifestyles. Data were analysed thematically. RESULTS Participants demonstrated understanding of what it means to be healthy, have a healthy diet, the dangers of substance misuse, and the benefits of exercise. Participants demonstrated some knowledge about rationales for engaging in healthy behaviours. The idea of moderation was raised, along with barriers and facilitators to engaging in a healthy lifestyle. CONCLUSIONS Findings suggest that people with ID demonstrate some understanding of what constitutes being healthy and are aware of healthy lifestyles, the consequences of unhealthy behaviours, and of the need for moderation.
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Affiliation(s)
- Sue Caton
- Research Institute for Health and Social Change, Manchester Metropolitan University, UK.
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Gait parameter adjustments for walking on a treadmill at preferred, slower, and faster speeds in older adults with down syndrome. Curr Gerontol Geriatr Res 2012; 2012:782671. [PMID: 22693497 PMCID: PMC3369407 DOI: 10.1155/2012/782671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 03/14/2012] [Accepted: 04/04/2012] [Indexed: 11/28/2022] Open
Abstract
The combined effects of ligamentous laxity, hypotonia, and decrements associated with aging lead to stability-enhancing foot placement adaptations during routine overground walking at a younger age in adults with Down syndrome (DS) compared to their peers with typical development (TD). Our purpose here was to examine real-time adaptations in older adults with DS by testing their responses to walking on a treadmill at their preferred speed and at speeds slower and faster than preferred. We found that older adults with DS were able to adapt their gait to slower and faster than preferred treadmill speeds; however, they maintained their stability-enhancing foot placements at all speeds compared to their peers with TD. All adults adapted their gait patterns similarly in response to faster and slower than preferred treadmill-walking speeds. They increased stride frequency and stride length, maintained step width, and decreased percent stance as treadmill speed increased. Older adults with DS, however, adjusted their stride frequencies significantly less than their peers with TD. Our results show that older adults with DS have the capacity to adapt their gait parameters in response to different walking speeds while also supporting the need for intervention to increase gait stability.
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Wuang Y, Su CY. Patterns of participation and enjoyment in adolescents with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:841-848. [PMID: 22245731 DOI: 10.1016/j.ridd.2011.12.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 12/08/2011] [Accepted: 12/08/2011] [Indexed: 05/28/2023]
Abstract
This study aimed to determine participation and enjoyment in young people with Down syndrome (DS) in Taiwan and to assess how participation varies across gender, cognitive, and motor function variables. Using the Children's Assessment of Participation and Enjoyment, data on participation were collected from 997 adolescents with DS and their families. Findings indicated limited diversity and intensity of participation, with proportionately greater involvement in informal activities. Youth with better cognitive and motor functions participated more often in activities and reported higher enjoyment and social engagement with these. These findings provide a foundation for an improved understanding of activity participation of youth with DS. Service providers and families could provide and plan activities to ensure more satisfying and meaningful participation.
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Affiliation(s)
- Yeepay Wuang
- Department of Occupational Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Esposito PE, MacDonald M, Hornyak JE, Ulrich DA. Physical activity patterns of youth with Down syndrome. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 50:109-119. [PMID: 22642965 DOI: 10.1352/1934-9556-50.2.109] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to examine the physical activity patterns of children with Down syndrome. A cross-sectional approach and accelerometry were used to measure the time children with Down syndrome (N = 104) spent in sedentary, light, and moderate-to-vigorous physical activity. Results indicated that adolescents from ages 14 to 15 years were the most sedentary and spent the least amount of time in light and moderate-to-vigorous physical activity. A general trend of decreasing physical activity as children increase in age was found. This trend is similar to that found among typically developing youth. Participants in this study were found to spend a majority of their day engaged in sedentary activities. Results indicate that most participants were not accumulating the recommended 60 minutes of moderate or vigorous physical activity.
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Affiliation(s)
- Phil E Esposito
- Department of Kinesiology, Texas Christian University, Fort Worth, TX 76129, USA.
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25
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Oates A, Bebbington A, Bourke J, Girdler S, Leonard H. Leisure participation for school-aged children with Down syndrome. Disabil Rehabil 2011; 33:1880-9. [DOI: 10.3109/09638288.2011.553701] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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26
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Olson LE, Mohan S. Bone density phenotypes in mice aneuploid for the Down syndrome critical region. Am J Med Genet A 2011; 155A:2436-45. [PMID: 21915988 DOI: 10.1002/ajmg.a.34203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 05/21/2011] [Indexed: 11/11/2022]
Abstract
Down syndrome (trisomy 21) is associated with reduced bone density in humans, but it is unclear whether this is due to specific effects of chromosome 21 genes or lifestyle factors. Mouse models with aneuploidy of segments of mouse chromosome 16 that are homologous to human chromosome 21 can be used to elucidate the mechanism by which Down syndrome phenotypes arise. Ts1Rhr and Ms1Rhr mice are trisomic and monosomic, respectively, for the hypothesized "Down syndrome critical region" containing approximately 33 genes. We assessed the skeletons of these mice from 3 to 16 weeks of age using dual X-ray absorptiometry. Ts1Rhr mice were unexpectedly similar to normal controls, showing that a larger region of trisomy is necessary to recapitulate the Down syndrome phenotype. Ms1Rhr mice, in contrast, showed decreases in weight, bone mineral content, bone mineral density, and bone area from weaning to adulthood. Regional bone density was also decreased in the femur, tibia, and lower lumbar spine. The microarchitecture of 3 week old Ms1Rhr femurs was then analyzed using µCT. Volumetric density, total tissue volume, bone volume, and bone fraction were all reduced in both cortical and trabecular bone. Ms1Rhr trabeculae were thinner and had decreased connectivity. A 31.5% reduction in the level of insulin-like growth factor I in the serum was found, and we hypothesize that this is responsible for the bone density phenotype. We discuss bone-related genes in the region and propose that humans with distal chromosome 21 deletions may exhibit reduced bone density.
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Affiliation(s)
- Lisa E Olson
- Musculoskeletal Disease Center, Loma Linda University, California, USA.
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28
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Marks B, Sisirak J, Hsieh K. Health services, health promotion, and health literacy: report from the State of the Science in Aging with Developmental Disabilities Conference. Disabil Health J 2011; 1:136-42. [PMID: 21122722 DOI: 10.1016/j.dhjo.2008.04.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Revised: 04/30/2008] [Accepted: 04/30/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND This article summarizes the proceedings of the Health Services, Health Promotion, and Health Literacy work group that was part of the "State of the Science in Aging with Developmental Disabilities: Charting Lifespan Trajectories and Supportive Environments for Healthy Living." Participants aimed to identify unmet needs related to health and health care and to determine training, research, and policy needs addressing the demands for increasing health care services and resources, end-of-life and palliative care, and health literacy. METHODS Key issues addressed included (1) major health-related disparities for adults with intellectual and developmental disabilities (I/DD); (2) the impact of internal and external factors on health care services and resources, end-of-life and palliative care, and health literacy for adults with I/DD; and (3) frameworks that can be used for understanding and promoting health care services and resources, end-of-life and palliative care, and health literacy. RESULTS Group participants identified research and practice needs related to primary care, health promotion, disease prevention, illness care, end-of-life issues, and palliative care. CONCLUSIONS Health care services for adults with I/DD may occur in a variety of settings including community-based programs, private practices, and community-based agencies supporting persons with disabilities. Major gaps relate to health disparities due to underdiagnosis, misdiagnosis, less chance of receiving prompt treatment, limited access to providers, lack of research information, transportation barriers, and lack of accessible medical equipment. Models of care including variables related to translation, sustainability, accessibility (e.g., affordability, availability), acceptability (e.g., culturally relevant, satisfaction), and equity need to be developed.
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Affiliation(s)
- Beth Marks
- Rehabilitation Research and Training Center on Aging with Developmental Disabilities and Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL 60608-6904, USA.
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29
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Daunhauer LA, Fidler DJ. The down syndrome behavioral phenotype: implications for practice and research in occupational therapy. Occup Ther Health Care 2011; 25:7-25. [PMID: 23898980 DOI: 10.3109/07380577.2010.535601] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
ABSTRACT Down syndrome (DS) is the most common chromosomal cause of intellectual disability. The genetic causes of DS are associated with characteristic outcomes, such as relative strengths in visual-spatial skills and relative challenges in motor planning. This profile of outcomes, called the DS behavioral phenotype, may be a critical tool for intervention planning and research in this population. In this article, aspects of the DS behavioral phenotype potentially relevant to occupational therapy practice are reviewed. Implications and challenges for etiology-informed research and practice are discussed.
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Affiliation(s)
- Lisa A Daunhauer
- 1Department of Occupational Therapy, Colorado State University, Fort Collins, Colorado, USA
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30
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Hsieh K, Heller T, Freels S. Residential characteristics, social factors, and mortality among adults with intellectual disabilities: transitions out of nursing homes. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2009; 47:447-465. [PMID: 20020800 DOI: 10.1352/1934-9556-47.6.447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Accepted: 03/26/2009] [Indexed: 05/28/2023]
Abstract
The present study examined the degree to which residential characteristics and social factors are associated with mortality, after controlling for personal characteristics, among adults with intellectual disabilities who have resided in nursing homes (facilities providing skilled care and related services) at baseline in the Chicago area. Initial assessments were conducted on 330 residents, and 2 follow ups were performed over 10 years. Seventy-one residents had died by the end of the study. The variables examined included personal characteristics of age, gender, intellectual level, health, and adaptive behavior; residential characteristics of type of residence, size of facility, attractiveness of physical environment (cleanliness, conditions, and aesthetic appeal), and diversity of physical environment (personalization of residents' rooms and distinctiveness of all living spaces); and social factors of family involvement and community integration. The results indicated, beyond age, adaptive behavior, and health, that size of residences, residential characteristics, and social factors are related to mortality.
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Affiliation(s)
- Kelly Hsieh
- Disability and Human Development, University of Illinois, Chicago, IL 60612-4394, USA.
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Humphries K, Traci MA, Seekins T. Nutrition and adults with intellectual or developmental disabilities: systematic literature review results. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2009; 47:163-185. [PMID: 19489663 DOI: 10.1352/1934-9556-47.3.163] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Accepted: 10/08/2008] [Indexed: 05/27/2023]
Abstract
Approximately 4.5 million Americans have an intellectual or developmental disability. Concern is increasing about these individuals' nutrition-related behavior and its implications for their health. This article reports on a systematic search of the current literature listed in the PsycINFO and PubMed databases related to nutritional status of adults with intellectual or developmental disabilities. The authors used key terms for nutrition, secondary conditions, and intellectual and developmental disability and categorized literature pertaining to nutrition-related studies of adults with intellectual or developmental disabilities as follows: dietary intake studies, anthropometric assessments of nutritional risks, biochemical indexes, and clinical evaluations.
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Affiliation(s)
- Kathleen Humphries
- University of Montana Rural Institute on Disabilities, Research Unit, Missoula, MT, USA.
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32
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Bodde AE, Seo DC. A review of social and environmental barriers to physical activity for adults with intellectual disabilities. Disabil Health J 2009; 2:57-66. [DOI: 10.1016/j.dhjo.2008.11.004] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 11/07/2008] [Accepted: 11/11/2008] [Indexed: 12/01/2022]
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Smith BA, Ulrich BD. Early onset of stabilizing strategies for gait and obstacles: older adults with Down syndrome. Gait Posture 2008; 28:448-55. [PMID: 18359229 PMCID: PMC2633770 DOI: 10.1016/j.gaitpost.2008.02.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 02/12/2008] [Accepted: 02/14/2008] [Indexed: 02/02/2023]
Abstract
Our goal was to examine the gait patterns of older adults with Down syndrome (DS) for precocious stabilizing adaptations during comfortable over-ground walking and in more challenging conditions. Twelve participants with DS and 12 with typical development (TD) were matched for height, weight and age (range 35-62 years). We used a six-camera motion capture system to assess foot trajectories over obstacles. Participants first walked at their preferred speed over a 5.3 m instrumented gait mat (unperturbed condition). Subsequent walking trials included perturbations mid-walkway: (a) minimal obstacle to step over (12 cm high), (b) moderate obstacle to step onto with both feet and then off (standard step), and (c) maximum obstacle to step onto with only one foot and over with the other (standard step). Adults with DS walked slower with shorter, wider strides while spending more time in both stance and double support. These adaptations increased during the moderate and maximal perturbations. They stepped with the minimal perturbation obstacle further forward in their crossing step and produced a lower, flatter trajectory of the lead foot, with less dorsiflexion at crossing. This strategy decreased trailing toe clearance but did not alter leading heel clearance. The combined effects of ligamentous laxity, low tone, obesity, inactivity and physiological decrements associated with aging lead to these stability-enhancing adaptations at a younger chronological age in adults with DS. We believe intervention to increase overall stability will be beneficial in helping adults with DS maintain optimal functional mobility and health.
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Affiliation(s)
- Beth A Smith
- University of Michigan, Division of Kinesiology, 401 Washtenaw Ave., Ann Arbor, MI 48109-2214,
| | - Beverly D Ulrich
- University of Michigan, Division of Kinesiology, 1402 Washington Heights, Ann Arbor, MI 48109-2013,
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NUTRITION AND DISABILITY. Nutr Diet 2008. [DOI: 10.1111/j.1747-0080.2008.00294.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The number of people over the age of 60 years with lifelong developmental delays is predicted to double by 2030. Down syndrome (DS) is the most frequent chromosomal cause of developmental delays. As the life expectancy of people with DS increases, changes in body function and structure secondary to aging have the potential to lead to activity limitations and participation restrictions for this population. The purpose of this update is to: (1) provide an overview of the common body function and structure changes that occur in adults with DS as they age (thyroid dysfunction, cardiovascular disorders, obesity, musculoskeletal disorders, Alzheimer disease, depression) and (2) apply current research on exercise to the prevention of activity limitations and participation restrictions. As individuals with DS age, a shift in emphasis from disability prevention to the prevention of conditions that lead to activity and participation limitations must occur. Exercise programs appear to have potential to positively affect the overall health of adults with DS, thereby increasing the quality of life and years of healthy life for these individuals.
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Affiliation(s)
- Robert C Barnhart
- Department of Physical Therapy, East Tennessee State University, Box 70624, Johnson City, TN 37614, USA.
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Jurkowski JM, Paul-Ward A. Photovoice With Vulnerable Populations: Addressing Disparities in Health Promotion Among People With Intellectual Disabilities. Health Promot Pract 2007; 8:358-65. [PMID: 17652188 DOI: 10.1177/1524839906292181] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cardiovascular diseases (CVD) are the leading causes of death among Mexican American adults living in the United States. Using data from a modified Behavioral Risk Factor Surveillance Survey and guided by the Anderson model, this study examined the effect of nativity on CVD screening practices among 423 Mexican American adults in Chicago. Dependent variables included having had a blood pressure and cholesterol screening and a routine checkup in the past 2 years. Multivariate analyses were used to control for sociodemographic factors while accounting for complex sampling design. Compared to those born in Mexico, U.S.-born Mexican Americans had greater odds of obtaining blood pressure (OR = 5.61) and cholesterol screenings (OR = 1.60) and having a routine checkup (OR = 2.69) in the past 2 years. Health professionals wishing to increase screenings for CVD risk factors among Mexican Americans in northern cities should understand the impact of nativity on screening practices.
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Affiliation(s)
- Janine M Jurkowski
- Department of Health Policy, Management, and Behavior, University at Albany, SUNY, School of Public Health, USA
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Jones MC, Walley RM, Leech A, Paterson M, Common S, Metcalf C. Behavioral and Psychosocial Outcomes of a 16-Week Rebound Therapy-Based Exercise Program for People With Profound Intellectual Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2007. [DOI: 10.1111/j.1741-1130.2007.00108.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Melville CA, Hamilton S, Hankey CR, Miller S, Boyle S. The prevalence and determinants of obesity in adults with intellectual disabilities. Obes Rev 2007; 8:223-30. [PMID: 17444964 DOI: 10.1111/j.1467-789x.2006.00296.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
People with intellectual disabilities experience significant health inequalities compared with the general population, including a shorter life expectancy and high levels of unmet health needs. Another accepted measure of health inequalities, the prevalence of obesity, has been shown to be higher in adults with intellectual disabilities than in the general population. While the factors contributing to the increased prevalence among adults with intellectual disabilities are not well understood, the high rates of obesity among younger adults highlight the need for further research involving children and adolescents with intellectual disabilities. To take forward the priorities for research and the development of effective, accessible services, there is a need for collaboration between professionals working in the fields of intellectual disabilities and obesity.
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Affiliation(s)
- C A Melville
- Section of Psychological Medicine, University of Glasgow, Glasgow, UK.
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Ordonez FJ, Rosety-Rodriguez M. Correlation between glutathione peroxidase activity and anthropometrical parameters in adolescents with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2007; 28:105-8. [PMID: 16563697 DOI: 10.1016/j.ridd.2006.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 02/21/2006] [Indexed: 05/08/2023]
Abstract
Since we have recently found that regular exercise increased erythrocyte antioxidant enzyme activities such as glutathione peroxidase (GPX) in adolescents with Down syndrome, these programs may be recommended. This study was designed to assess the role of anthropometrical parameters as easy, economic and non-invasive biomarkers of GPX. Thirty-one adolescents with Down syndrome performed a 12-week training program. Three days after its ending, GPX activity and anthropometrical parameters were assessed. Pearson's correlation coefficient showed negative but significant association (r=0.49, p=0.022) between GPX activity and waist circumference (WC). Body mass index (BMI) and waist-to-hip ratio (WHR) were not significant. We may conclude that anthropometrical parameters such as WC are easy to perform but not strongly associated to GPX activity. Further studies concerning other variables are needed.
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Affiliation(s)
- F J Ordonez
- Medicine Department, School of Sport Medicine, University of Cadiz, Pza. Fragela s/n, 11003 Cadiz, Spain
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Jones MC, Walley RM, Leech A, Paterson M, Common S, Metcalf C. Using goal attainment scaling to evaluate a needs-led exercise programme for people with severe and profound intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2006; 10:317-35. [PMID: 17105740 DOI: 10.1177/1744629506070051] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The aim of this study was to evaluate whether involvement in a 16 week exercise programme improved goal attainment in areas of behaviour, access to community-based experiences, health and physical competence. Participants were women with severe intellectual disability and associated challenging behaviour (setting A,N = 14) and male/female service users with profound physical and intellectual disabilities (setting B,N = 8). The exercise programme included active and passive exercise, walking, swimming, hydrotherapy, team games and rebound therapy. Significant gains in aggregated goal attainment were demonstrated by week 16. The reliability and validity of our goal attainment procedures were demonstrated with inter-rater reliabilities exceeding 80 percent. Changes in goal attainment were concurrent with global clinical impression scores in a series of single case studies. Continuing care settings should dedicate care staff to provide routinized, continuing exercise programmes.
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Affiliation(s)
- Martyn C Jones
- School of Nursing and Midwifery, University of Dundee, Scotland, UK.
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van den Akker M, Maaskant MA, van der Meijden RJM. Cardiac diseases in people with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2006; 50:515-22. [PMID: 16774636 DOI: 10.1111/j.1365-2788.2006.00797.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND In people with ID there is more morbidity than in the general population, including cardiac diseases. Dutch figures on this subject are scarce. METHODS Descriptive study of the prevalence of cardiac diseases in 436 residential clients in Echt, the Netherlands, and comparisons between men and women, age groups, and level and aetiology of ID, were carried out. RESULTS It was found that the total prevalence of cardiac diseases was 14%, with a higher prevalence among women, the elderly, and people with mild/moderate ID. CONCLUSIONS The prevalence of cardiac diseases in residential clients is substantial. With the increasing number of ageing people with ID and people with ID living more independently in community-integrated residences, it is expected that the morbidity and mortality from cardiac diseases will increase further.
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Affiliation(s)
- M van den Akker
- Department of General Practice, Maastrict University, Maastricht, the Netherlands.
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Abstract
While much of the industrialized world struggles for clues to the growing rise in obesity in their respective countries, researchers and service providers involved in understanding the health characteristics and health behaviors of persons with intellectual disability (ID) struggle with their own issues regarding the increased prevalence of obesity in this segment of the population. What is particularly alarming is that adults with ID residing in the United States in smaller, less supervised settings (e.g., group homes and family households) have a significantly higher rate of obesity compared to other countries and those living in larger and more supervised settings (e.g., institutions). These differences support the theory that the environment appears to exert a powerful influence on obesity in this population. Obesity presents a substantial threat to the livelihood of persons with ID and may have an effect on community participation, independent living, and healthy years of life. The lack of research on successful weight reduction strategies for obese persons with ID makes this an important and greatly needed area of research.
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Affiliation(s)
- James H Rimmer
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL 60608-6904, USA.
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Moran R, Drane W, McDermott S, Dasari S, Scurry JB, Platt T. Obesity among people with and without mental retardation across adulthood. ACTA ACUST UNITED AC 2005; 13:342-9. [PMID: 15800293 DOI: 10.1038/oby.2005.46] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study was designed to explore obesity during adulthood and the likelihood of moving out of obesity among 1809 adults without disability and 680 adults with mental retardation who received care at the same primary care practices during the period of 1990 to 2003. RESEARCH METHOD AND PROCEDURES A retrospective observational design using medical records first identified patients with mental retardation (MR) and age-matched controls without disabilities. Data on BMI collected during each primary care visit allowed exploration of obesity at three levels. Moving out of obesity was defined as having a BMI <25 kg/m(2). We also abstracted data on age, sex, race, and other medical conditions. RESULTS For adults 20 to 29 years of age, 33.1% of patients without disability and 21% of patients with MR had a BMI >30 kg/m(2). Between the ages of 50 and 59 years, 40.5% of the patients without disability and 35.2% of the patients with MR had a BMI >30 kg/m(2). Patients with mild MR had similar prevalence rates of obesity and patients with severe MR had significantly lower prevalence of obesity compared with the patients without disability through 50 years of age. Throughout the period from 20 to 60 years of age, between 15% and 40% of individuals with and without MR, who were previously obese, were not currently obese. DISCUSSION Throughout the adult years, an increasing proportion of individuals with and without MR are obese. However, obesity is not a chronic state; many people transition back to a normal body weight.
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Affiliation(s)
- Robert Moran
- Department of Epidemiology and Biostatistics, University of South Carolina School of Public Health, Columbia, South Carolina, USA
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Hahn JE, Aronow HU. A Pilot of a Gerontological Advanced Practice Nurse Preventive Intervention. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2005. [DOI: 10.1111/j.1468-3148.2005.00242.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Emerson E. Underweight, obesity and exercise among adults with intellectual disabilities in supported accommodation in Northern England. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2005; 49:134-143. [PMID: 15634322 DOI: 10.1111/j.1365-2788.2004.00617.x] [Citation(s) in RCA: 157] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Significant deviation from normal weight (obesity and underweight) and lack of physical exercise have been identified as three of the most significant global behavioural risks to health. METHODS Body mass index (BMI) and levels of physical activity were measured in a sample of 1542 adults with intellectual disabilities (ID) receiving supported accommodation in nine geographical localities in Northern England. Comparative population data were extracted from the Health Survey for England 1998 and 2001. RESULTS Men and women with ID living in supported accommodation are at increased risk of being significantly underweight and physically inactive. Women with ID living in supported accommodation are at increased risk of obesity. Within the population of people with ID living in supported accommodation increased behavioural health risks are associated with gender, severity of ID, age and location. CONCLUSION Significant deviation from normal weight and lack of physical exercise are significant behavioural risks to health among people with ID.
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Affiliation(s)
- E Emerson
- Institute for Health Research, Lancaster University, Lancaster LA1 4YT, UK.
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Melville CA, Cooper SA, McGrother CW, Thorp CF, Collacott R. Obesity in adults with Down syndrome: a case-control study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2005; 49:125-133. [PMID: 15634321 DOI: 10.1111/j.1365-2788.2004.00616.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Obesity has a negative impact upon mortality and morbidity. Studies report that obesity is more prevalent in individuals with Down syndrome than individuals with intellectual disabilities (ID) not associated with Down syndrome. However, there have been no studies using a methodology of matched comparison groups and findings from previous studies are contradictory. METHODS A detailed method was used to identify all adults with ID in Leicestershire. Individuals were invited to participate in a medical examination - that included measurement of their height and weight, from which body mass index (BMI) was calculated. For each person with Down syndrome, an individual matched for gender, age and accommodation type was identified, from the Leicestershire ID database. RESULTS The data for 247 matched pairs is reported. Women with Down syndrome had lower mean height and weight, but greater mean BMI than the matched pairs. Men with Down syndrome had a lower mean height and weight but there was no statistical difference in BMI compared to the matched pairs. Using World Health Organization categories of BMI, women with Down syndrome were more likely to be overweight or obese than their matched pairs (odds ratio = 2.17). Men with Down syndrome were more likely to be in the overweight category than their matched pairs but were less likely to be obese (odds ratio = 0.85). CONCLUSIONS This study demonstrates that, compared to a matched sample, there is a greater prevalence of obesity amongst women with Down syndrome but not men. As the impact on the health of people with Down syndrome of being overweight or obese is uncertain, this is an area that requires further study.
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Affiliation(s)
- C A Melville
- Section of Psychological Medicine, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow 0XH, UK
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Gravestock S. Diagnosis and classification of eating disorders in adults with intellectual disability: the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) approach. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2003; 47 Suppl 1:72-83. [PMID: 14516376 DOI: 10.1046/j.1365-2788.47.s1.41.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Previous classifications of eating disorders [EDs] employed a narrower concept of EDs. They did not include the wide range of abnormal eating behaviours [AEBs], persistent feeding disorders and EDs psychopathology, aetiological and comorbidity factors seen in adults with intellectual disability [ID]. METHODS The International Classification of Diseases--10 [ICD-10], ICD-10-MR, Diagnostic and Statistical Manual--IV [DSM-IV] and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation[DC-LD] diagnostic approaches to EDs in adults with ID are compared. RESULTS The DC-LD encourages conceptually clearer and systematic hierarchical differential diagnostic classification of AEBs and EDs. The DC-LD also allows consideration of relevant aetiological and comorbidity issues. DC-LD-based multi-axial case formulation supports the multimodal clinical assessment of AEBs and EDs. CONCLUSIONS Further research should develop similar systematic and evidence-based multicomponent clinical diagnostic, management and service models for adults with ID and EDs.
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Abstract
The sequencing of chromosome 21 and the use of models of Down's syndrome in mice have allowed us to relate genes and sets of genes to the neuropathogenesis of this syndrome, and to better understand its phenotype. Research in prenatal screening and diagnosis aims to find methods to identify fetuses with Down's syndrome, and reduce or eliminate the need for amniocentesis. Other areas of active research and clinical interest include the association of Down's syndrome with coeliac disease and Alzheimer's disease, and improved median age of death. Medical management of the syndrome requires an organised approach of assessment, monitoring, prevention, and vigilance. Improvements in quality of life of individuals with Down's syndrome have resulted from improvements in medical care, identification and treatment of psychiatric disorders (such as depression, disruptive behaviour disorders, and autism), and early educational interventions with support in typical educational settings. Approaches and outcomes differ throughout the world.
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Marshall D, McConkey R, Moore G. Obesity in people with intellectual disabilities: the impact of nurse-led health screenings and health promotion activities. J Adv Nurs 2003; 41:147-53. [PMID: 12519273 DOI: 10.1046/j.1365-2648.2003.02522.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. AIM Firstly, to follow-up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. METHODS A clinic led by two learning disability nurses was held for all people aged 10 years and over (n = 464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organized health promotion classes for 20 people over a 6- or 8-week period. FINDINGS The health screen identified 64% of adults and 26% of 10-19-year olds as being overweight or obese. Moreover, those aged 40-49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow-up questionnaire sent after 3 months suggested that of the 122 people identified for weight reduction, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. CONCLUSIONS Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabilities to create more active lifestyles.
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Affiliation(s)
- David Marshall
- Down Lisburn Health and Social Services Trust, Disability Resource Centre, Downpatrick, UK
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Draheim CC, Williams DP, McCubbin JA. Prevalence of physical inactivity and recommended physical activity in community-based adults with mental retardation. MENTAL RETARDATION 2002; 40:436-44. [PMID: 12408746 DOI: 10.1352/0047-6765(2002)040<0436:popiar>2.0.co;2] [Citation(s) in RCA: 161] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Little information has been reported on the leisure time physical activity (LTPA) habits of adults with mental retardation. Prevalence of physical inactivity and recommended LTPA of adults with mild to moderate mental retardation who live in community settings was described. Adults with mental retardation (76 men, 74 women) reported their physical activity habits. Overall, men and women who resided in community settings were similarly inactive, with 47% to 51% of individuals participating in little to no LTPA. Forty-two to 47% of them reported participation in moderate to vigorous LTPA five or more times per week. Limitations to quantifying physical activity through questionnaire process is discussed and development and implementation of programs designed to increase physical activity levels recommended.
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Affiliation(s)
- Christopher C Draheim
- Division of Kinesiology, University of Minnesota, 27T URC, 1900 University Ave SE, Minneapolis, MN 55455, USA.
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