Respiratory-associated deaths in people with intellectual disabilities: A systematic review and meta-analysis

Maria Truesdale*, Craig Melville, Fiona Barlow, Kirsty Dunn, Angela Henderson, Laura Anne Hughes-Mccormack, Arlene McGarty, Ewelina Rydzewska, Gillian S Smith, Joseph Symonds, Bhautesh Jani, Deborah Kinnear

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective To review and synthesise evidence on rates of respiratory-associated deaths and associated risk factors in the intellectual disability population.

Design Systematic review and meta-analysis.

Data sources Embase, CINAHL, ISI Web of Science (all databases including Medline) and PsychINFO were searched for studies published between 1st January 1985 and 27th April 2020 and examined study and outcome quality. Reference lists and Google Scholar were also hand searched.

Results We identified 2295 studies, 17 were included in the narrative synthesis and 10 studies (11 cohorts) in the meta-analysis. Data from 90 302 people with intellectual disabilities and 13 808 deaths from all causes in people with intellectual disabilities were extracted. Significantly higher rates of respiratory-associated deaths were found among people with intellectual disabilities (standardised mortality ratio(SMR): 10.86 (95% CI: 5.32 to 22.18, p<0.001) compared with those in the general population, lesser rates for adults with ID (SMR: 6.53 (95% CI: 4.29 to 9.96, p<0.001); and relatively high rates from pneumonia 26.65 (95% CI: 5.63 to 126.24, p<0.001). The overall statistical heterogeneity was I2=99.0%.

Conclusion Premature deaths due to respiratory disorders are potentially avoidable with improved public health initiatives and equitable access to quality healthcare. Further research should focus on developing prognostic guidance and validated tools for clinical practice to mitigate risks of respiratory-associated deaths.
Original languageEnglish
Article numbere043658
JournalBMJ Open
Issue number7
Early online date14 Jul 2021
Publication statusE-pub ahead of print - 14 Jul 2021


Dive into the research topics of 'Respiratory-associated deaths in people with intellectual disabilities: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this