Journal of Intellectual Disability Research最新文献_第8页

Parental Education Predicts Longitudinal IQ Trajectories in 22q11.2 Deletion Syndrome: A Three-Cohort European Study 父母教育预测22q11.2缺失综合征的纵向智商轨迹：一项欧洲三队列研究。

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-08-04 DOI: 10.1111/jir.70025

Yelyzaveta Snihirova, Therese van Amelsvoort, Ann Swillen, Marianne van den Bree, Dennis van der Meer, Janet Harwood, Claudia Vingerhoets, David E. J. Linden

Background

22q11.2 deletion syndrome (22q11DS) is a genetic disorder characterised by a wide range of physical, cognitive, and psychiatric symptoms. Current knowledge on 22q11DS highlights considerable variation in cognitive outcomes, but the role of environmental factors in shaping these trajectories over time remains poorly understood.

Aims

This study investigates how environmental factors contribute to variability in intelligence quotient (IQ) among individuals with 22q11DS across three European cohorts. By examining these influences over time, the research aims to identify potential drivers of IQ differences and uncover modifiable factors that may support improved cognitive outcomes in individuals with 22q11DS.

Methods

Data were collected from 297 individuals with 22q11DS across three European cohorts. Cognitive assessments included full-scale IQ (FSIQ), verbal IQ (VIQ) and performance IQ (PIQ). Environmental measures encompassed parental education, sleep, stress and substance use, gathered through questionnaires and interviews. Baseline associations between environmental measures and IQ were evaluated with ANOVA at the first assessment. To examine within-person IQ change across three visits, we used linear mixed-effects models.

Results

We found a significant decline in FSIQ, VIQ and PIQ over time, with linear trends observed for all three measures. Parental education, particularly the father's education, explained a significant proportion of the variance of all IQ-based measures.

Conclusions

Parental education emerged as a key predictor of IQ, suggesting that socioeconomic factors contribute to cognitive performance variability in individuals with 22q11DS. Even in high-penetrance genetic variants, such as the 22q11.2 deletion, environmental factors and gene–environment interactions may make significant contributions to the severity of phenotypes.

背景：22q11.2缺失综合征（22q11DS）是一种以广泛的身体、认知和精神症状为特征的遗传性疾病。目前关于22q11DS的知识强调了认知结果的相当大的变化，但随着时间的推移，环境因素在塑造这些轨迹中的作用仍然知之甚少。目的：本研究调查了环境因素如何影响欧洲三个22q11DS人群的智商差异。随着时间的推移，通过检查这些影响，该研究旨在确定智商差异的潜在驱动因素，并揭示可能支持改善22q11DS患者认知结果的可修改因素。方法：数据来自三个欧洲队列的297名22q11DS患者。认知评估包括全面智商（FSIQ）、语言智商（VIQ）和表现智商（PIQ）。环境措施包括父母教育、睡眠、压力和物质使用，通过问卷调查和访谈收集。在第一次评估时，采用方差分析评估环境措施与智商之间的基线关联。为了检查三次访问期间的个人智商变化，我们使用了线性混合效应模型。结果：我们发现FSIQ， VIQ和PIQ随着时间的推移显着下降，所有三个测量都观察到线性趋势。父母的教育，尤其是父亲的教育，解释了所有基于智商的测量差异的重要比例。结论：父母教育是智商的关键预测因素，这表明社会经济因素对22q11DS个体的认知表现差异有影响。即使在高外显率的遗传变异中，如22q11.2缺失，环境因素和基因-环境相互作用也可能对表型的严重程度做出重大贡献。

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引用次数: 0

Online Health Literacy Resources for People With Intellectual Disability: A Grey Literature Scoping Review 智障人士在线健康素养资源：灰色文献综述

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-08-02 DOI: 10.1111/jir.70028

Jessica Keeley, Zhenmei Yeap, Rachel Skoss, Thomas Nevill, Susan Hunt, Jacinta Saldaris, Jenny Downs

Background

People with intellectual disability experience higher rates of physical and mental health problems than those without intellectual disability. Health literacy includes accessing, understanding, appraising and applying health information. Improving health literacy is associated with better health outcomes. The internet is a primary source of health information for many people. This study aimed to evaluate available online health resources for people with intellectual disability and their families to understand information gaps.

Method

A scoping review of grey literature was conducted using two searches: a targeted search of disability organisation websites and an advanced Google search using key terms. The methods were guided by a modified version of Arksey and O'Malley's methodological approach.

Results

A total of 1165 health resources for people with intellectual disability and their families were identified. Tests, checks and procedures were the most common category of health addressed (n = 227, 19.5%) and most content was directed at the individual with intellectual disability (n = 837, 71.9%). Resources addressed the health literacy domains of accessing (n = 1165, 100%) and understanding (n = 1132, 97.2%) information more often than appraising (n = 575, 49.5%) and applying (n = 415, 35.6%).

Conclusions

Improving the health literacy of people with intellectual disability is an important part of addressing health disparities and requires understanding of the available information. Some information gaps were identified, including limited sexual health resources and mental health resources for adolescents.

背景：智力残疾者的身心健康问题发生率高于无智力残疾者。健康素养包括获取、理解、评价和应用健康信息。提高卫生知识素养与改善健康结果有关。互联网是许多人获取健康信息的主要来源。本研究旨在评估智障人士及其家庭可用的在线健康资源，以了解信息差距。方法：对灰色文献进行范围审查，使用两个搜索：残疾人组织网站的目标搜索和使用关键术语的高级谷歌搜索。这些方法是由Arksey和O'Malley的方法方法的修改版本指导的。结果：共确定智障人士及其家庭卫生资源1165个。测试、检查和程序是最常见的健康类别（n = 227, 19.5%），大多数内容针对智力残疾个体（n = 837, 71.9%）。资源更多地涉及获取（n = 1165, 100%）和理解（n = 1132, 97.2%）信息的健康素养领域，而不是评价（n = 575, 49.5%）和应用（n = 415, 35.6%）。结论：提高智力残疾者的健康素养是解决健康差距的重要组成部分，需要了解现有信息。发现了一些信息缺口，包括青少年性健康资源和心理健康资源有限。

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引用次数: 0

Identifying and Describing Best Clinical Practices for Children and Adolescents With Complex Communication Needs: A Scoping Review of Healthcare-Based Interventions 识别和描述具有复杂沟通需求的儿童和青少年的最佳临床实践：基于医疗保健干预措施的范围审查。

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-31 DOI: 10.1111/jir.70022

Paula Resina, Marcela Mezzatesta, Neus Elias, Melina Aparici, Maria A. Mairena

Background

Children with complex communication needs (CCN), particularly those with autism spectrum disorder (ASD), experience significant communication challenges. This scoping review analyses the existing literature on clinical interventions designed to enhance communication in these children. The aim was to describe which intervention models are being evaluated in studies, which treatments have shown positive effects and what the clinical profile of children and adolescents who benefit from these interventions is.

Method

The scoping review was conducted following the methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

Results

The search strategy identified 797 records; eight records met all eligibility criteria and were included for review. The review found that multimodal interventions combining augmentative and alternative communication (AAC), naturalistic strategies and parent training were the most effective in improving both expressive and receptive communication.

Conclusions

Despite the limited existing research, studies suggest that multimodal interventions can effectively enhance communication in children with CCN. This review highlights significant gaps in the literature, including the scarcity of studies with appropriate methodological rigour and the lack of standardised protocols for CCN interventions. There is a critical need for evidence-based guidelines, professional training and policy development to ensure equitable access to effective interventions.

背景：具有复杂沟通需求（CCN）的儿童，尤其是自闭症谱系障碍（ASD）儿童，面临着巨大的沟通挑战。本综述分析了旨在加强这些儿童沟通的临床干预措施的现有文献。其目的是描述哪些干预模式正在研究中进行评估，哪些治疗已经显示出积极的效果，以及从这些干预中受益的儿童和青少年的临床情况。方法：按照范围评价的方法学和范围评价的首选报告项目和范围评价的meta分析扩展（PRISMA-ScR）进行范围评价。结果：搜索策略识别出797条记录；8项记录符合所有资格标准并纳入审查。本研究发现，结合辅助和替代沟通（AAC）、自然主义策略和家长训练的多模式干预在改善表达性和接受性沟通方面最有效。结论：尽管现有研究有限，但研究表明，多模式干预可以有效增强CCN患儿的沟通。这篇综述强调了文献中的重大空白，包括缺乏具有适当方法严谨性的研究和缺乏CCN干预措施的标准化方案。迫切需要以证据为基础的指南、专业培训和政策制定，以确保公平获得有效的干预措施。

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引用次数: 0

Comparing Levels of Positive Mental Well-Being and Life Satisfaction Between Mothers and Fathers of Children With an Intellectual Disability 智障儿童父母积极心理健康及生活满意度之比较。

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-26 DOI: 10.1111/jir.70021

Marina Antoniadou, Vaso Totsika, Emma Langley, Richard P. Hastings, Caitlin A. Williams

Background

Positive mental health is experienced by parents of children with intellectual disability and has been shown to be associated with child mental health outcomes in these families. There is a dearth of evidence on mother–father differences in levels of positive mental health, despite evidence of differences in levels of mental health problems. This study aimed to compare levels of positive mental health, namely life satisfaction and mental well-being, between mothers and fathers of children with an intellectual disability.

Method

Participants were 85 mother–father dyads participating in the 1000 Families Study, a UK-based cohort study of families of children with intellectual disability. Approximately 92% of the dyads were a couple, while the rest reported they were divorced, separated or not living with the child's other parent. Over 90% of participants were the child's biological parent. The mean age of mothers and fathers was 45 years old and 50.5 years old, respectively. Children were on average 14.8 years old (ages ranged from 9 to 20 years old) and over 70% were boys.

Results

Multilevel models initially showed no differences between mothers' and fathers' mental well-being and life satisfaction. After controlling for other factors potentially related to positive mental health, findings indicated that life satisfaction was reported at higher levels by mothers compared with fathers of children with intellectual disability.

Conclusions

Subject to replication in future studies, initial evidence of gender differences in life satisfaction highlights that fathers of children with an intellectual disability may be particularly vulnerable to lower levels of positive mental health. Fathers may require additional support for achieving positive mental health.

背景：积极的心理健康是智力残疾儿童的父母所经历的，并且已被证明与这些家庭的儿童心理健康结果有关。尽管有证据表明心理健康问题的程度存在差异，但缺乏证据表明父母在积极心理健康水平上存在差异。本研究旨在比较智障儿童的母亲和父亲的积极心理健康水平，即生活满意度和心理健康水平。方法：参与者是参加1000个家庭研究的85对父母二人组，这是一项基于英国的智力残疾儿童家庭队列研究。大约92%的二人组是一对夫妻，而其余的则离婚、分居或不和孩子的另一位父母住在一起。超过90%的参与者是孩子的亲生父母。母亲和父亲的平均年龄分别为45岁和50.5岁。儿童的平均年龄为14.8岁（9至20岁），超过70%是男孩。结果：多水平模型初步显示母亲和父亲的心理健康和生活满意度没有差异。在控制了其他可能与积极心理健康相关的因素后，研究结果表明，智力残疾儿童的母亲比父亲报告的生活满意度更高。结论：生活满意度的性别差异的初步证据表明，智力残疾儿童的父亲可能特别容易受到较低水平的积极心理健康的影响，这需要在未来的研究中得到证实。父亲可能需要额外的支持来实现积极的心理健康。

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引用次数: 0

Ten-Year Outcomes of Anticholinergic Use Among Older Adults With Intellectual Disability: Findings From the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) 智力残疾老年人使用抗胆碱能药物的十年结果：来自智力残疾补充到爱尔兰老龄化纵向研究（IDS-TILDA）的发现。

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-26 DOI: 10.1111/jir.70018

Lamya Al Shuhaimi, Ian D. Maidment, Martin C. Henman, Phyo K. Myint, Juliette O'Connell, Caitríona Ryan, Philip McCallion, Mary McCarron, Maire O'Dwyer

Background

People with intellectual disability are frequently exposed to medication with anticholinergic activity. In the general population, the long-term exposure to anticholinergics has been associated with declines in both physical and cognitive function. This study aimed to examine anticholinergic exposure longitudinally in a cohort of older adults with intellectual disability (aged 40 years or over).

Method

The study examined individuals with intellectual disability aged 40 and over, who participated at two time points (Waves 1 and 4), 10 years apart, in the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). The Anticholinergic Cognitive Burden (ACB) scale was used to quantify anticholinergic exposure. Logistic regression analysis was employed to examine the adverse outcomes reported at time point 2 in relation to ACB scores at time point 1. Models were adjusted for age, gender, level of intellectual disability, residence, epilepsy and polypharmacy.

Results

The study included 487 participants who provided medication data at both time points. Anticholinergic exposure remained consistent over the studied period, with approximately 30% having no exposure, 40% having mild exposure (ACB = 1–4) and 30% having high exposure (ACB = 5+). Antipsychotic medications contributed the most to the total score at both time points (Wave 1 = 35%, Wave 4 = 37%), with other anticholinergics, antiepileptics and antidepressant medications contributing 10%–16% each. Mild and high ACB scores at time point 1 were significantly associated with a higher risk of falls (odds ratio [OR] = 1.86, 95% CI: 1.03–3.38) and mental health conditions (ACB 1–4; OR = 6.60, 95% CI: 3.69–11.77; ACB 5+, OR = 17.38, 95% CI: 8.97–33.61) and lower OR for reporting dementia/Alzheimer's disease (ACB 1–4; OR = 0.39, 95% CI: 0.15–0.97; ACB 5+; OR = 0.21, 95% CI: 0.07–0.64).

Conclusion

Older adults with intellectual disability are exposed to high anticholinergic burden at the two time points, 10 years apart. Being exposed to anticholinergics at Wave 1 is significantly associated with a higher risk of falls and reporting mental health conditions at Wave 4. A review of antipsychotic prescribing practice is urgently needed to reduce the anticholinergic exposure and its adverse outcomes among older adults with intellectual disability.

背景：智力障碍患者经常接触具有抗胆碱能活性的药物。在一般人群中，长期接触抗胆碱能药物与身体和认知功能下降有关。本研究旨在纵向检查智力残疾老年人（40岁或以上）的抗胆碱能暴露。方法：该研究调查了40岁及以上的智力残疾患者，他们在两个时间点（波1和波4）参加了爱尔兰老龄化纵向研究（IDS-TILDA）的智力残疾补充，间隔10年。采用抗胆碱能认知负担（ACB）量表量化抗胆碱能暴露。采用Logistic回归分析来检验时间点2报告的不良结果与时间点1的ACB评分的关系。对模型进行了年龄、性别、智力残疾水平、居住地、癫痫和多种药物的调整。结果：该研究包括487名参与者，他们提供了两个时间点的用药数据。在研究期间，抗胆碱能暴露保持一致，约30%没有暴露，40%轻度暴露（ACB = 1-4）， 30%高暴露（ACB = 5+）。在两个时间点，抗精神病药物对总分的贡献最大（波1 = 35%，波4 = 37%），其他抗胆碱能药物、抗癫痫药物和抗抑郁药物各贡献10%-16%。时间点1的轻度和高ACB评分与较高的跌倒风险（优势比[OR] = 1.86, 95% CI: 1.03-3.38）和精神健康状况(ACB 1-4；Or = 6.60, 95% ci: 3.69-11.77；ACB 5+, OR = 17.38, 95% CI: 8.97-33.61)，报告痴呆/阿尔茨海默病的OR较低(ACB 1-4；Or = 0.39, 95% ci: 0.15-0.97；ACB 5 +;Or = 0.21, 95% ci: 0.07-0.64)。结论：老年智障患者在两个时间点（间隔10年）暴露于高抗胆碱能负荷。在第1波中暴露于抗胆碱能药物与第4波中较高的跌倒风险和报告的精神健康状况显著相关。迫切需要对抗精神病药处方实践进行回顾，以减少老年智力残疾患者的抗胆碱能暴露及其不良后果。

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引用次数: 0

Oral Health and Pneumonia in Adults With Intellectual and Developmental Disabilities: A Scoping Review 智力和发育障碍成人的口腔健康与肺炎：范围综述

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-15 DOI: 10.1111/jir.70013

Katrina Byrne, Dominika Lisiecka, Gary Moran, Blánaid Daly, Isabel Fleischmann, Philip McCallion, Mary McCarron, Caoimhin Mac Giolla Phadraig

Introduction

Pneumonia is a leading cause of death for people with intellectual and developmental disabilities (IDD), who also have increased risk of oral disease. Given the known relationship between oral disease and pneumonia in similar populations, this review aims to explore what is known about the association between oral health and pneumonia among people with IDD.

Methods

This systematic scoping review was carried out in accordance with the Joanna Briggs Institute methods and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist (PRISMA-ScR). A systematic search of Medline (Ovid), Embase, Cochrane Trials, Cochrane Review, CINAHL and PubMed was conducted, guided by a registered protocol. The PCC framework informed the search and inclusion criteria. Titles and abstracts were independently screened by two reviewers, with full texts assessed for relevance to oral health and pneumonia in adults with IDD.

Results

Following a protocol and defined criteria, (2544) articles were abstract screened; a further (31) reached full-text review, with (7) included in this review. Study designs included cross-sectional studies (2), retrospective cohorts (2), prospective cohorts (2) and one RCT pilot (1). Six studies reported oral carriage of respiratory pathogens such as Streptococcus pneumoniae, Pseudomonas aeruginosa and Klebsiella pneumoniae. Two studies reported predictive relationships between oral pathogens and pneumonia, with increased odds of respiratory illness associated with positive PCR results for specific pathogens (OR 9.0, 95% confidence interval [CI] 2.3–38.8). Two studies identified poor oral health as a predictor of pneumonia, using validated tools such as the ROAG (OR 1.6, 95% CI 1.1–2.5). Mediating factors included enteral feeding, level of IDD, and history of oral disease.

Conclusions

Research consistently finds carriage of potential respiratory pathogens in the oral microbiome of people with IDD. Despite this, there is a significant lack of research into the relationship between the oral microbiome, poor oral health, and pneumonia in this population, though the latter two are both prevalent and consequential. There is an urgent need for further research exploring the role that oral health and the oral microbiome play in pneumonia among people with IDD.

肺炎是智力和发育障碍（IDD）患者死亡的主要原因，他们患口腔疾病的风险也增加。鉴于已知在相似人群中口腔疾病与肺炎之间的关系，本综述旨在探讨IDD患者口腔健康与肺炎之间的已知关系。方法：按照Joanna Briggs研究所的方法和系统评价和荟萃分析扩展范围评价清单的首选报告项目（PRISMA-ScR）进行系统范围评价。系统检索Medline （Ovid）、Embase、Cochrane Trials、Cochrane Review、CINAHL和PubMed，并以注册方案为指导。PCC框架为搜索和纳入标准提供了信息。标题和摘要由两位审稿人独立筛选，并评估全文与IDD成人口腔健康和肺炎的相关性。结果：按照一个方案和定义的标准，对2544篇文章进行了摘要筛选；另有（31）例达到全文审查，其中(7)例纳入本审查。研究设计包括横断面研究（2项）、回顾性队列研究（2项）、前瞻性队列研究（2项）和一个随机对照试验（1项）。六项研究报告了呼吸道病原体的口腔携带，如肺炎链球菌、铜绿假单胞菌和肺炎克雷伯菌。两项研究报告了口腔病原体与肺炎之间的预测关系，特定病原体PCR阳性结果与呼吸道疾病的几率增加相关（OR 9.0, 95%可信区间[CI] 2.3-38.8）。两项研究使用ROAG等经过验证的工具（OR为1.6,95% CI为1.1-2.5）确定口腔健康状况不佳是肺炎的预测因子。介导因素包括肠内喂养、碘缺乏症水平和口腔疾病史。结论：研究一致发现，IDD患者的口腔微生物群中携带潜在的呼吸道病原体。尽管如此，在这一人群中，口腔微生物群、口腔健康状况不佳和肺炎之间的关系的研究明显缺乏，尽管后两者既普遍又重要。迫切需要进一步研究口腔健康和口腔微生物组在IDD患者肺炎中的作用。

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引用次数: 0

Neurobehavioural Patterns in the Diagnosis of Autism Spectrum Disorder in Down Syndrome 唐氏综合症自闭症谱系障碍诊断中的神经行为模式。

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-15 DOI: 10.1111/jir.70015

Lina R. Patel, Meghan O'Neill, Gabriel Anzueto, Darren Olsen, Katherine Pawlowski, Jonathan D. Santoro, Georgios Sideridis, Noemi Spinazzi, Nicole T. Baumer

Background

Autism spectrum disorder (ASD) is common in Down syndrome (DS). There are no standardised screening/assessment tools for evaluating ASD in DS.

Methods

We utilised a novel validated questionnaire, the ND-PROM, to investigate differences in developmental skills and behaviours among children with DS only, ASD only and DS + ASD.

Results

Data analysis using ANOVA tests and post hoc t-tests revealed item-level differences between groups in domains specific to ASD (nonverbal communication, social–emotional understanding, social interaction, independent play, restrictive and repetitive behaviours and interests and sensory processes) and not specific to ASD (expressive language, receptive language, adaptive/toileting, challenging behaviours, mental health and impulse/ADHD).

Conclusion

ASD-specific symptoms best distinguished DS only and DS + ASD groups, while non-ASD symptoms best distinguished ASD only and DS + ASD groups. Items that best differentiate groups are presented.

背景：自闭症谱系障碍（ASD）常见于唐氏综合征（DS）。没有标准化的筛查/评估工具来评估残疾儿童的自闭症。方法：我们使用了一种新的有效问卷，ND-PROM，来调查仅DS，仅ASD和DS + ASD儿童的发展技能和行为的差异。结果：使用方差分析和事后t检验的数据分析显示，在ASD特有的领域（非语言交流、社会情感理解、社会互动、独立游戏、限制性和重复性行为、兴趣和感觉过程）和非ASD特有的领域（表达语言、接受语言、适应/如厕、挑战行为、心理健康和冲动/多动症）中，各组之间存在项目水平的差异。结论：ASD特异性症状最能区分DS组和DS + ASD组，非ASD症状最能区分DS组和DS + ASD组。展示了最能区分各组的项目。

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引用次数: 0

The Mental Health and Well-Being of Adults With Intellectual Disabilities During the COVID-19 Pandemic Across the UK: A Four-Wave Longitudinal Analysis 英国COVID-19大流行期间智力残疾成年人的心理健康和福祉：四波纵向分析

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-15 DOI: 10.1111/jir.70006

Amanda Gillooly, Paul Thompson, Jill Bradshaw, Sue Caton, Chris Hatton, Andrew Jahoda, Rosemary Kelly, Roseann Maguire, Edward Oloidi, Laurence Taggart, Stuart Todd, the Coronavirus and People With Learning Disabilities Study Team, Richard P. Hastings

Background

Research concerning the impact of the COVID-19 pandemic on the mental health and well-being of adults with intellectual disabilities has been cross-sectional and small scale. We examined the trajectory of mental health and well-being across the pandemic period across the UK and the factors which predicted different mental health trajectories.

Method

Adults with intellectual disabilities participated in co-designed structured interviews. Four waves of data were collected between December 2020 and late 2022. At Wave 1, 621 adults with intellectual disabilities participated, with 355 at Wave 4. Well-being, pandemic anxiety, depression, anxiety, anger and loneliness outcomes were measured. Latent class mixed modelling was used to identify subgroups and within-group trajectories.

Results

Well-being and pandemic anxiety remained relatively stable across time, but levels of anger, depression, anxiety and loneliness reduced gradually over time. Overall patterns masked trajectory subgroups, with differences in intercept and steepness of decline or increase in mental health problems. Different factors were generally influential for trajectory class membership and overall change across time for outcomes. Leaving the house for exercise or green spaces reported increasing well-being and reduced loneliness. Similarly, those working, volunteering or in education at Wave 1 were found to have increasing well-being and reduced loneliness, sadness and worry, and increasing wellbeing and reducing anger if they were working pre-pandemic.

Conclusions

Social connection and engagement in purposeful activity were vital to maintaining the mental health and well-being of people with intellectual disabilities. Factors that were found to reduce mental well-being during the pandemic should be considered in planning for future major public health challenges and in promoting better mental well-being for people with intellectual disabilities in everyday life.

背景：关于COVID-19大流行对智力障碍成人心理健康和福祉影响的研究一直是横向和小规模的。我们研究了整个英国大流行时期的心理健康和福祉轨迹，以及预测不同心理健康轨迹的因素。方法：成人智障患者参与共同设计的结构化访谈。在2020年12月至2022年底期间收集了四波数据。在第1轮中，621名智力残疾的成年人参与，在第4轮中有355名。测量了幸福感、流行病焦虑、抑郁、焦虑、愤怒和孤独的结果。潜在类别混合模型用于识别亚组和组内轨迹。结果：幸福感和大流行焦虑在一段时间内保持相对稳定，但愤怒、抑郁、焦虑和孤独的水平随着时间的推移逐渐降低。总体模式掩盖了轨迹亚组，在心理健康问题下降或增加的截点和陡峭程度上存在差异。不同的因素一般影响轨迹、班级成员和结果随时间的总体变化。据报道，离开家去锻炼或绿地会增加幸福感，减少孤独感。同样，那些在第一波工作、志愿服务或接受教育的人被发现幸福感增加，孤独感、悲伤和担忧减少，如果他们在大流行前工作，幸福感增加，愤怒减少。结论：社会联系和参与有目的的活动对维持智力残疾者的心理健康和福祉至关重要。在规划未来的重大公共卫生挑战和促进智力残疾者在日常生活中改善心理健康时，应考虑到在大流行期间发现的影响心理健康的因素。

{"title":"The Mental Health and Well-Being of Adults With Intellectual Disabilities During the COVID-19 Pandemic Across the UK: A Four-Wave Longitudinal Analysis","authors":"Amanda Gillooly, Paul Thompson, Jill Bradshaw, Sue Caton, Chris Hatton, Andrew Jahoda, Rosemary Kelly, Roseann Maguire, Edward Oloidi, Laurence Taggart, Stuart Todd, the Coronavirus and People With Learning Disabilities Study Team, Richard P. Hastings","doi":"10.1111/jir.70006","DOIUrl":"10.1111/jir.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Research concerning the impact of the COVID-19 pandemic on the mental health and well-being of adults with intellectual disabilities has been cross-sectional and small scale. We examined the trajectory of mental health and well-being across the pandemic period across the UK and the factors which predicted different mental health trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Adults with intellectual disabilities participated in co-designed structured interviews. Four waves of data were collected between December 2020 and late 2022. At Wave 1, 621 adults with intellectual disabilities participated, with 355 at Wave 4. Well-being, pandemic anxiety, depression, anxiety, anger and loneliness outcomes were measured. Latent class mixed modelling was used to identify subgroups and within-group trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Well-being and pandemic anxiety remained relatively stable across time, but levels of anger, depression, anxiety and loneliness reduced gradually over time. Overall patterns masked trajectory subgroups, with differences in intercept and steepness of decline or increase in mental health problems. Different factors were generally influential for trajectory class membership and overall change across time for outcomes. Leaving the house for exercise or green spaces reported increasing well-being and reduced loneliness. Similarly, those working, volunteering or in education at Wave 1 were found to have increasing well-being and reduced loneliness, sadness and worry, and increasing wellbeing and reducing anger if they were working pre-pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Social connection and engagement in purposeful activity were vital to maintaining the mental health and well-being of people with intellectual disabilities. Factors that were found to reduce mental well-being during the pandemic should be considered in planning for future major public health challenges and in promoting better mental well-being for people with intellectual disabilities in everyday life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16163,"journal":{"name":"Journal of Intellectual Disability Research","volume":"69 10","pages":"1132-1142"},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jir.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Central Blood Pressure and Augmentation Index in Older Adults With Intellectual Disabilities 老年智力障碍患者的中心血压和增高指数。

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-14 DOI: 10.1111/jir.70002

T. I. M. Hilgenkamp, A. Oppewal, M. N. Bohmer, A. Paul, C. Ryan, E. Burke, M. McCarron, P. McCallion, D. A. M. Maes-Festen, F. O'Brien

Background

Older adults with intellectual disabilities are at a higher cardiovascular risk than their peers in the general population. Investigating central blood pressure and augmentation index is necessary to better understand the risk of cardiovascular disease, to better identify those individuals at risk and to potentially change pharmacological treatment regimens. We therefore aim to investigate central blood pressure and augmentation index in two large cohorts (total N = 237) of older adults with intellectual disabilities, across different age ranges and sexes. Additionally, we will explore the cross-sectional relationships of central blood pressure and augmentation index with other cardiovascular risk factors and the presence of cardiovascular disease across a broad age range.

Method

Collected data of two cohorts of older adults with intellectual disabilities were included: n = 121 individuals with intellectual disabilities of ≥ 60 years from the Healthy Ageing and Intellectual Disabilities (HA-ID) study, and n = 115 individuals with intellectual disabilities ≥ 40 years from The Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) study. The Mobil-O-Graph was used to measure central blood pressure and augmentation index. The distribution of haemodynamic measures across different sex and age groups was reported, and bivariate correlations were calculated to explore associations between haemodynamic measures, cardiovascular risk factors and history of CVD.

Results

Mean brachial pressures for the HA-ID cohort (mean age 71 ± 6 years) was 133/81 mmHg. The slightly younger IDS-TILDA cohort (mean age 60 ± 9 years) had a median brachial blood pressure of 127/81. Mean central SBP (cSBP) in the older HA-ID cohort was 122 mmHg versus 120 mmHg in the younger IDS-TILDA cohort, with a central DBP (cDBP) of 82 mmHg in both cohorts, and a central pulse pressure (cPP, cSBP-cDBP) of 40 mmHg for the HA-ID cohort and 38 mmHg for the IDS-TILDA cohort.

Conclusions

Females with intellectual disabilities had higher central blood pressures, augmentation pressure and augmentation index than males, and females showed an age-related increase in central blood pressures.

背景：患有智力障碍的老年人患心血管疾病的风险高于普通人群中的同龄人。调查中心血压和升高指数对于更好地了解心血管疾病的风险，更好地识别那些有风险的个体，并可能改变药物治疗方案是必要的。因此，我们的目的是在两个大型队列（总N = 237）中调查不同年龄和性别的智力残疾老年人的中心血压和增强指数。此外，我们将在广泛的年龄范围内探讨中心血压和增强指数与其他心血管危险因素和心血管疾病存在的横断面关系。方法：收集两组智力残疾老年人的数据：n = 121例来自健康老龄化和智力残疾（HA-ID）研究的≥60岁的智力残疾个体，n = 115例来自爱尔兰老龄化纵向研究的智力残疾补充（IDS-TILDA）研究的≥40岁的智力残疾个体。mobilo - graph测量中心血压和升高指数。报告了血流动力学指标在不同性别和年龄组的分布，并计算了双变量相关性，以探讨血流动力学指标、心血管危险因素和CVD病史之间的关联。结果：HA-ID队列的平均臂压（平均年龄71±6岁）为133/81 mmHg。稍年轻的IDS-TILDA队列（平均年龄60±9岁）的中位肱血压为127/81。老年HA-ID队列的平均中央收缩压（cSBP）为122 mmHg，而年轻IDS-TILDA队列为120 mmHg，两个队列的中心舒张压（cDBP）均为82 mmHg， HA-ID队列的中心脉压（cPP, cSBP-cDBP）为40 mmHg， IDS-TILDA队列为38 mmHg。结论：女性智力障碍患者的中心血压、增压压和增压指数均高于男性，且女性中心血压呈年龄相关性增高。

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引用次数: 0

Effectiveness of Psychosocial Interventions for Youth With Mild Intellectual Disabilities or Borderline Intellectual Functioning and Externalising Problems: A Multilevel Meta-Analysis 心理社会干预对青少年轻度智障或边缘性智障及外化问题的有效性：一项多水平元分析。

IF 2 2区医学 Q1 EDUCATION, SPECIAL

Journal of Intellectual Disability Research

Pub Date : 2025-07-14 DOI: 10.1111/jir.70014

Eva Kühl, Ina M. Koning, Maja Deković, Sander Thomaes, Juliëtte M. Liber

Objectives

This meta-analysis examined the effectiveness of psychosocial interventions for youth with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) and externalising problems.

Methods

We assessed 2221 studies for eligibility and included seven studies containing 14 effect sizes. We used a multilevel modelling approach to analyse the data and calculated two different types of effect sizes: one for controlled trials and one for intervention pre-test to post-test effects (across all studies).

Results

Both controlled trial effect sizes (g = 0.49) and pre-test to post-test effect sizes were significant (g = 0.53). We were unable to detect heterogeneity of effects because of the small number of eligible studies. The risk of bias was generally high.

Discussion

Results suggest that psychosocial interventions decrease externalising problems among youth with MID-BIF. Effect sizes appear similar to those for youth without MID-BIF. We discuss recommendations for how the field can move forward.

目的：本荟萃分析检验了心理社会干预对轻度智力残疾或边缘性智力功能（MID-BIF）和外化问题青年的有效性。方法：我们评估了2221项研究的合格性，包括7项研究，包含14个效应量。我们使用多层次建模方法来分析数据，并计算了两种不同类型的效应量：一种用于对照试验，另一种用于干预前测试到后测试效应（所有研究）。结果：对照试验效应量（g = 0.49）和前测对后测效应量均显著（g = 0.53）。由于符合条件的研究数量较少，我们无法检测效果的异质性。偏倚的风险普遍较高。讨论：结果表明心理社会干预减少了中期bif青少年的外化问题。效应大小与没有中等bif的年轻人相似。我们讨论了该领域如何向前发展的建议。

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引用次数: 0