Factors associated with obesity and coronary heart disease in people with intellectual disabilities

Advances in health care for people with intellectual disabilities (ID) that have resulted in increased longevity also force health care providers, researchers, and policymakers to question the adequacy of chronic disease management for the growing number of middle aged and elderly persons in this population. We report on sociodemographic and clinical factors associated with obesity, hypertension, hypercholesterolemia, and diabetes mellitus in an ethnically/racially diverse sample of people with ID in New York City. Administrative and chart review data were collected from a community-based specialty medical practice for people with intellectual disabilities. Adult subjects were included if they had an intellectual disability, lived in the community either independently or with relatives, received all of their planned, outpatient health care services though this practice, and had a primary care visit within the study period. One hundred twenty-six (43.0%) persons were obese, 58 (19.9%) had hypertension, 77 (26.5%) had hypercholesterolemia, and 13 (4.5%) had diabetes mellitus. Age, gender, and BMI (for the latter three conditions) were the most consistent risk factors. Intellectual functioning and behavioral problems were not associated with greater odds of these conditions. This study provides crucial information for improving community-based primary care for people with intellectual disabilities. Specifically, these findings highlight the importance of constructing innovative strategies to mitigate chronic disease risk factors in this population that involve community-based case management service providers who can help adults with ID and their families adopt needed lifestyle and behavior changes.