State-Level Variation in Cardiovascular Risk Among Adult Athletes with Intellectual and Developmental Disabilities

Background and Purpose:Over the last fifty years, medical advances and improvements in treatment and living conditions have led to substantial growth in life expectancy for people with intellectual and developmental disabilities (IDD). As in the general population, individuals with IDD are at increased risk of developing cardiovascular disease (CVD) as they age. Recent research examining risk factors for CVD within this population has been small-scale in nature, and results have been inconsistent. Further examination of CVD in adults with IDD is necessary for targeting prevention efforts aimed at improving quality of life for those aging with IDD. This study examined state-level variation in the relationship between age and CVD risk among adults with IDD. We hypothesized that there would be significant state-level variability in the relationship between age and CVD risk such that in some states younger individuals with IDD would experience more CVD risk, or accelerated aging. This was hypothesized given state-level variability in policies and availability of programs that may support physical health in adults with IDD.

Methods:Data are from 11,417 athletes with IDD collected by Special Olympics International during free health screenings held before athletic events in 37 U.S. states. Participants were aged 16-97 (M=31.23), and 57% were male. Variability in mean systolic blood pressure (SBP), or CVD risk, was examined by state. A random-coefficient model of CVD risk was estimated with group mean centered age as the predictor using hierarchical linear modeling. The correlation between age and CVD risk was calculated by state to examine accelerated aging.

Results: CVD risk varied across states. South Dakota had the highest mean SBP (M=132.26, SD=9.33) and Arizona had the lowest mean SBP (M=115.32, SD=14.57). Results of the random-coefficient model indicated that there was a significant positive relationship between age and CVD risk (γ₁₀=.153, p<.001) such that a ten-unit increase in age increased CVD (SBP) by 1.53 points. There was significant between-group variation in mean CVD risk after controlling for age (χ²(36)=854.846, p<.001) and in the relationship between age and CVD risk (accelerated aging) (χ²(36)=73.205, p<.001). Correlation coefficient values indicated that accelerated aging was strongest in Utah (r=-.665) and weakest in South Carolina (r=.441).

Conclusions and Implications: Findings indicate a significant relationship between aging and CVD risk even among Special Olympics participants who can be considered a healthier group of people with IDD. Findings also show that the relationship between aging and CVD risk varies significantly by state (is not static), indicating that possibilities exist for reducing accelerated aging and CVD risk among people with IDD. These results underscore the need to identify factors that predict CVD risk in adults with IDD in order to enhance prevention and intervention efforts. Social workers can play a vital role in designing and implementing effective health promotion programs for people with IDD.