Respiratory mortality


Background:

Respiratory disorders are a leading cause of death among people with learning/intellectual disabilities including preventable and treatable conditions such as pneumonia and aspiration. 

Higher rates of asthma, chronic obstructive pulmonary disease and upper respiratory tract infections have been reported for people with learning/intellectual disabilities.  People with profound and multiple learning/intellectual disabilities are particularly at risk of infections including pneumonia and gastro-oesophageal reflux disease.

Respiratory disease has been reported to be amongst the most common cause of death in children and young people with learning/intellectual disabilities, however the findings on respiratory-associated mortality are inconsistent.

What we did:

We systematically reviewed all studies and analysed available data for deaths (n=1,844) from respiratory disorders in people with learning/intellectual disabilities from the last 35 years.

What we found:

This study found that people with learning/intellectual disabilities are up to 11 times more likely to die from respiratory illness compared to the general population. In adults with learning/intellectual disabilities, this risk is 6 times higher compared to the general population.

We also found that the risk of death from pneumonia was 27 times higher for people with learning/intellectual disabilities compared to the general population, with influenza and injury from inhalation and aspiration events being common contributing factors

Many respiratory deaths among people with learning/intellectual disabilities are avoidable, with leading causes of death due to conditions that are treatable and amenable to good quality health and care.

What this means:

These findings demonstrate the need for further investigation of the risk factors associated with respiratory deaths in people with learning/intellectual disabilities and the need for improvements in primary prevention, such as training to increase awareness among carers and clinicians of the link between dysphagia and recurrent chest infections.

Further action to reduce community acquired pneumonia for people with learning/intellectual disabilities, through targeted vaccination programmes are recommended in order to increase uptake.

Understanding the risk factors for respiratory associated deaths has important implications for disease management, the development of preventative strategies as well as for policy and practice to reduce premature deaths from respiratory-associated conditions. 

The original paper, Respiratory-associated deaths in people with intellectual disabilities: a systematic review and meta-analysis, is available online via the BMJ Open

You can also access an Easy Read version of this paper and a Policy Briefing by clicking on the tabs below. 

Page last updated 15th July 2021.