International Variation in Health Risk Factors and Accelerated Aging in Adult Athletes with Intellectual and Developmental Disabilities

Background/Purpose:Worldwide, adults with intellectual and developmental disabilities (IDD) are living longer due to advances in condition management and treatment. However, improvements in longevity necessitate an increased need to monitor health risk factors, such as obesity and cardiovascular function, as individuals with IDD age. To enhance health prevention efforts and address health risk, Special Olympics International (SOI), a global nonprofit organization supporting more than 4.2 million athletes with IDD word-wide, offers free health screenings at SOI events. This study utilized international data collected by SOI during these health screenings to examine world regional differences in obesity rates and cardiovascular function and assess the relationship between age and health risk in adults with IDD.

Methods:This study utilized data from 47,625 athletes with IDD collected by SOI during free health screenings in seven world regions (Africa [n=1,996], Asia-Pacific [n=1,776], East Asia [n=4,661], Europe [n=10,750], Latin America [n=7,535], Middle East [n=1,068], and North America [n=19,811]) between 2007 and 2013. Participants were aged 16-97 (M=27.23), and 61% were male. Variability in mean body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were examined by world region. These measures were then converted to a z-metric, and a composite health risk variable was created. A random-coefficient model of health risk was estimated with group mean centered individual age as the predictor using hierarchical linear modeling. The correlation between age and blood pressure and age and BMI was calculated by region to examine accelerated aging.

Results: BMI, SBP, and DBP varied across world regions. North America had the highest mean BMI (M=29.565, SD=7.670), SBP (M=121.692, SD=15.296), and DBP (M=75.199, SD=10.921) while Africa had the lowest BMI (M=21.737, SD=3.935), Latin America had the lowest SBP (M=113.269, SD=11.756), and East Asia had the lowest DBP (M=70.833, SD=10.044). Results of the random-coefficient model indicated that there was a significant positive relationship between age and health risk (γ₁₀=.019, p<.001). This suggests that a one-unit increase in age increased health risk by .019 standard deviations. There was significant between-group variation in mean health risk after controlling for age (χ²(6)=10807.255, p<.001), and in the relationship between age and health risk (accelerated aging; χ²(6)=390.662, p<.001). The reliabilities of intercept and slope were .997 and .924, respectively, indicating that the intercept and slope of the regression equation were reliably estimated. Correlation coefficient values indicated that accelerated aging was strongest in East Asia (BP: r=.072, p<.001; BMI: r=.101, p<.001) and weakest in Asia-Pacific (BP: r=.275, p<.001; BMI: r=.332, p<.001). Accelerated aging was indicated in North America (BP: r=.109, p<.001; BMI: r=.143, p<.001).

Conclusions/Implications: Findings indicate that world regions vary significantly in health risk and accelerated aging and that North America fares poorly in both of these areas. Notably, this research included only athletes with IDD, indicating that health risk and accelerated aging are still present in a more active and thus likely healthier population of individuals with IDD. Social workers can play a key role in promoting culturally responsive health and well-being in adults with IDD across the lifespan.