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Cardiovascular Disease Incidence and Risk Factors in Older Adults With Intellectual Disabilities: Results of the

Marleen J de Leeuw1,2, Mylène N Böhmer1,2, Patrick J E Bindels3

  • 1Department of General Practice, Intellectual Disability Medicine Research, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Journal of Intellectual Disability Research : JIDR
|July 2, 2025
PubMed

Insights

Older adults with intellectual disabilities face higher risks for heart failure and stroke. Managing hypertension and antipsychotic use is crucial for their cardiovascular health.

Area of Science:

  • Gerontology
  • Cardiology
  • Intellectual Disabilities Research

Background:

  • Older adults with intellectual disabilities (ID) exhibit heightened vulnerability to cardiovascular diseases (CVD).
  • Limited longitudinal data exists on CVD incidence and risk factors within this demographic.
  • Understanding these factors is vital for targeted healthcare strategies and resource allocation.

Purpose of the Study:

  • To determine the incidence of cardiovascular diseases (CVD) in older adults with intellectual disabilities.
  • To investigate associations between CVD incidence and participant characteristics or risk factors.

Main Methods:

  • A prospective longitudinal study design was employed.
  • Participants (age ≥50 years) with ID were followed from 2009-2010 to 2020-2023.
  • Incidence rates for myocardial infarction (MI), heart failure (HF), and stroke were calculated, with competing risk analysis used to assess risk factor associations.

Main Results:

  • Over a mean follow-up of 8.6 years, incidence rates were 2.3/1000 person-years for MI, 7.2 for HF, and 5.3 for stroke.
  • Hypertension (HR 3.17), Down syndrome (HR 2.66), and antipsychotic use (HR 1.98) significantly increased CVD risk.
  • Incidence of MI was lower, while HF and stroke incidence was similar to or higher than the general population.

Conclusions:

  • Older adults with ID show a lower MI incidence but comparable or higher rates of HF and stroke compared to the general population.
  • Hypertension and antipsychotic use are key modifiable risk factors for CVD in this group.
  • Further research, particularly on Down syndrome's association with CVD, is warranted, alongside proactive risk factor management.
Abstract

Keywords:
agedantipsychotic agentsblood pressurecardiac failurecerebrovascular accidentfollow‐up studiesintellectual disabilitylongitudinal studiesoccurrenceprospective studies

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