Ahead of this year's Learning Disability Today Conference, Jim Blair, consultant nurse learning (intellectual) disabilities, Great Ormond Street Hospital, looks at some of the more common health problems faced by people with learning disabilities.
Health professionals can struggle to identify what a learning disability is, in turn increasing the likelihood of poor care outcomes. A learning disability is ‘a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence) with a reduced ability to cope independently (impaired social functioning). Which started before adulthood, with a lasting effect on development’.
There are numerous people who are often considered to have a learning disability but who, in fact, do not, including those with dyspraxia, dyslexia, attention deficit disorder, Asperger’s syndrome or challenging behaviour. Occasionally, people with a physical or sensory impairment are considered to have a learning disability, which is also incorrect.
Individuals with learning disabilities will experience problems with recalling information, telling the time, conceptualising time, maintaining self-care and accompanying activities needed to maintain daily life skills. There are three core criteria which must be met for the term learning disability to apply:
- Significant impairment of intellectual function (learning new information, remembering and recalling dates, issues, events that would be within the expected for their age and culture)
- Significant impairment of adaptive and or social function (ability to cope on a day to day basis with the demands of his/her environment and the expectations of age and culture)
- Age of onset before adulthood.
Common health issues faced by people with a learning disability
- Gastrointestinal cancers, including those of the oesophagus, stomach and gall bladder, are approximately twice as prevalent in people with learning disabilities, while the prevalence of lung, cervical cancer prostate and breast are much lower than in the general population. Individuals with Down Syndrome are particularly susceptible lymphoblastic leukaemia
- Coronary heart disease is the second highest cause of death of people with a learning disability
- Dental problems and oral hygiene. People with learning disabilities are more likely to have tooth decay, loose teeth, untreated oral disease and gum disease than the average member of the general population
- Diabetes - the higher rate of diabetes than in the general population which could be due to a greater incidence of obesity, less activity and poorer diet
- Epilepsy - approximately one in three people with a learning disability has epilepsy, depending on severity of disability, compared with one in 100 of the general population
- Gastrointestinal problems - approximately 70% of people with learning disabilities experience gastrointestinal disorders, meaning they are far more prevalent in this patient group compared to the population as a whole
- Anxiety disorders, depression and schizophrenia are among the more common mental health problems experienced by people with learning disabilities. Schizophrenia, for example, is three times more common in people with learning disabilities than in the general population
- Obesity is far more common in people with learning disabilities, especially women with mild disabilities, than in the general population
- Respiratory disease is the most common cause of death of people with a learning disability
- Sensory impairments - approximately 40% per cent of people with learning disabilities have difficulties seeing and a similar proportion has problems hearing
- Swallowing and eating problems - difficulties in swallowing are far more common among individuals with learning disabilities than in the general population and are highest among those with profound learning disabilities.
Jim Blair will be writing on the issue of learning disabilities and the role of the GP for January's British Journal of Family Medicine.
Learning Disability Today takes place on 26 November 2015 at Olympia Conference Centre, London.
[First published November 2015]