Respiratory disease mortality in an institutionalised mentally retarded population

Mortality from respiratory diseases has been described in a large institution for the mentally retarded, from 1958 to 1973. Pneumonia continued to account for a large proportion of deaths (around forty per cent), when underlying causes of death were analysed. Age-specific death rates from pneumonia (underlying or contributory cause of death) showed little or no decline for ages five to sixty and over. Autopsy reports on 237 persons revealed high frequencies of bronchopneumonia, pulmonary congestion, pleurisy and aspiration pneumonia. Aspiration and its sequelae (aspiration pneumonia, lipid pneumonia) appears to be a major problem in this population, upon which prevention programmes could concentrate. Some risk factors associated with aspiration were also identified.