College of Medical, Veterinary & Life Sciences

A new study into respiratory-associated deaths by the Scottish Learning Disabilities Observatory (SLDO) has found that people with learning disabilities are almost 11 times more likely to die prematurely from respiratory disease compared to other people.

This unique study, published in the BMJ Open, examined data from more than 90,000 people with learning disabilities and 27,394 deaths, using literature published over the last 24 years. Deaths due to respiratory disease were found to be significantly higher for people with learning disabilities compared to those without learning disabilities. For adults with learning disabilities the risk of death was 6.5 times greater than it was for adults in the general population. The rate of death from pneumonia was almost 27 times higher.

Lead author, Dr Maria Truesdale, said: “The research highlighted a number of inequalities in the care of people with learning disabilities. People with learning disabilities are dying prematurely from causes that could be prevented. There is an urgent need for greater understanding and awareness across health and social care of the specific health and care needs of people with learning disabilities and in particular of the specific risk factors that contribute to premature deaths. We must act to now reduce preventable deaths.

“We are calling for a number of actions including raising awareness among primary care staff of the link between dysphagia and recurrent chest infections, action to increase uptake of relevant vaccination programmes in the population with learning disabilities and practice-based approaches to address the common risk factors related to a higher risk of respiratory-associated deaths.”

Dr Bhautesh Jani, GP and Clinical Senior Lecturer in Primary Care said: “The findings from this study have important implications for general practice. In the short term, primary care staff managing respiratory illness in people with learning disabilities need to consider significantly higher risk of mortality associated with these presentations. In the long term, factors contributing to observed higher mortality needs further research to improve primary care management and prevent premature mortality in people with learning disabilities.”

While the findings from this study unequivocally conclude that there are huge disparities in mortality rates for respiratory-associated deaths between people with learning disabilities and the general population, further research is required to understand more about the specific underlying causes which put people with learning disabilities at increased risk of premature death from respiratory diseases. Greater examination of the most effective clinical approaches is also required in order to manage and reduce risk.

The study was conducted by the Scottish Learning Disabilities Observatory, based in the Institute of Health and Wellbeing at the University of Glasgow. The Observatory is funded by the Scottish Government to help address the health inequalities experienced by people with learning disabilities through the provision of good quality evidence to support action.

The study, 'Respiratory-associated deaths in people with intellectual disabilities: a systematic review and meta-analysis' is published in the BMJ Open.

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First published: 27 July 2021