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Biomedical subjects

M A Maaskant

Publications and source records attributed to M A Maaskant.

11 recordsLinked to original sources

Cardiac diseases in people with intellectual disability.

BACKGROUND: In people with ID there is more morbidity than in the general population, including cardiac diseases. Dutch figures on this subject are scarce. METHODS: Descriptive study of the prevalence of cardiac diseases in 436 residential clients in Echt, the Netherlands, and comparisons between men and women, age groups, and level and aetiology of ID, were carried out. RESULTS: It was found that the total prevalence of cardiac diseases was 14%, with a higher prevalence among women, the elderly, and people with mild/moderate ID. CONCLUSIONS: The prevalence of cardiac diseases in residential clients is substantial. With the increasing number of ageing people with ID and people with ID living more independently in community-integrated residences, it is expected that the morbidity and mortality from cardiac diseases will increase further.

Adult↗

Prevalence and incidence of health problems in people with intellectual disability.

The objective of this study was to determine the prevalence and incidence of the most frequent chronic health problems in relation to age in people with intellectual disabilities living in residential facilities in the Netherlands. A prospective cohort study was done with four data collections, each with an interval of one year. Data were collected by means of questionnaires which were completed by each person's physician. Striking results included the reported high prevalence and incidence of visual and hearing impairment, which was even more pronounced in people with Down's syndrome than in people with intellectual disability resulting from other causes. Gastrointestinal problems also appeared to have high incidence rates. Dementia was frequently reported in people with Down's syndrome aged 40 years and older. The results reflect the need for a more predictive policy which can anticipate health problems in people with intellectual disability.

Adolescent↗

Care dependence and activities of daily living in relation to ageing: results of a longitudinal study.

From 1990 to 1993, the University of Limburg and the Pepijn Centre, the Netherlands, have performed a prospective cohort study on ageing and intellectual disability. The key questions of the study were: "To what degree do the level of care dependence and activities of daily living (ADL) differ between age groups, and to what degree do these skills change during the study period (3 years)? Are the changes age related?'. Looking at the changes in time, the results show that the level of care dependence did not change substantially in the sample of 1602 residents of Dutch facilities for people with intellectual disability. Only the oldest residents (70+ years) showed a significant decline in independence. The results also show that the skills of young people with Down's syndrome (< 40 years) did not change substantially, whereas older people with Down's syndrome (40+ years) showed a substantial decrease in ADL-skills. The ADL-skills of the residents with other aetiological diagnoses younger than 60 years of age did not change substantially, while the older residents (60-69 and 70+ years) showed a significant decrease in ADL-functions. The trend between changes in ADL and age in both aetiological groups was statistically significant. Attention is paid to the implications of these findings in the discussion.

Activities of Daily Living↗

[Drug use by mentally handicapped persons in institutions and family-replacing residential facilities].

OBJECTIVE: Description of use of medication by people with mental handicaps in relation to age, level of mental handicap and living facility. DESIGN: Cross-sectional study. SETTING: Institutions and group homes for people with mental handicaps in North Brabant and Limburg, the Netherlands. METHODS: Of a patient sample (n = 1265), stratified according to age and living facility (i.e. institution or group home) data were collected by means of questionnaires to be completed by the general practitioners. For 101 persons data about level of mental handicap were lacking. RESULTS: 57% of the patients used one or more drugs. The numbers of drugs used were significantly related to (increased) age and level of mental handicap. Older patients more often used antipsychotics, laxatives and cardiovascular medication, younger ones more often used anticonvulsants. More severely handicapped persons used antipsychotics, anticonvulsants, laxatives, antacids, psychoactive medication and gastrointestinal medication more often. There was no relationship between amount of medication and living facility. CONCLUSION: Many mentally handicapped use medication. Since epilepsy, psychiatric and behavioural diseases and gastrointestinal problems are frequent, and because the patients offer little spontaneous information, alertness with respect to drug interaction and side effects is indicated.

Adult↗

Care dependence and individual care provision.

For policy purposes as well as for the provision of individual care, it is relevant to known which individual characteristics have impact upon the level of care dependence. For purposes of individual care provision, characteristics which can be influenced and which also have an important impact upon the care dependence are of interest. This study showed that the profoundly mentally handicapped are almost all totally dependent upon care, and therefore additional information about individual characteristics is superfluous. The results of logistic regression analyses showed a statistically significant and important impact of ADL-functions. Exactly which other characteristics are relevant to consider depends upon the level of care dependence and the level of mental handicap.

Activities of Daily Living↗

The need for assessment of sensory functioning in ageing people with mental handicap.

Within the framework of a study on the ageing process of people with mental handicap in the Netherlands, information about visual and hearing impairments in 1583 people with mental handicap living in group homes or institutions was obtained from their physicians by means of a written questionnaire. Of the people with Down's syndrome (DS) who were older than 50 years of age, 46% had a visual impairment, whereas approximately 13% of subjects with other causes of mental handicap at the same age experienced similar visual impairment. Hearing loss in this age group was reported in 28% of people with DS, but only in 8% of subjects with other causes of mental handicap. The most common eye condition was cataracts, and the most frequent cause of hearing impairment was infection. In people with severe and profound mental handicap of all ages, sensory impairments were more frequent than in persons with mild or moderate mental handicap. Glasses or hearing aids were rarely used by people with severe or profound mental handicap. Assessment of visual and hearing impairments in people with mental handicap seemed clearly indicated, especially in those aged 50 years and older, in those with DS, and in those with severe or profound mental handicap.

Adolescent↗

Care dependence and services planning.

For policy purposes as well as for the provision of individual care, it is relevant to know which individual characteristics have an impact upon the level of care dependence. For policy purposes, it is preferable to predict the level of care dependence as efficiently as possible. This study of residents of institutions and group homes for people with mental handicap showed that profoundly mentally handicapped residents are almost all totally dependent upon care: additional information about the individual characteristics of this group is superfluous. The results of logistic regression analyses for residents with severe or mild mental handicap showed that age, gender and aetiological diagnosis (Down's syndrome or other) do not have significant predictive power. For the level of care dependence, adding the score on Activities of Daily Life (ADL) to the various models improved the predictive power. It depends on the level of mental handicap and on the level of care dependence which one wants to predict which other individual characteristics have to be included in order to improve predictive power.

Activities of Daily Living↗

Mental health problems in elderly people with and without Down's syndrome.

This article reports on age-specific findings of mental health problems among residents with Down's syndrome (DS) (n = 307) and without (non-DS) (n = 1274 in dutch group homes and institutes for people with mental retardation. Whereas a proportional increase of psychological problems was found for elderly DS persons with severe mental retardation, non-DS residents did not show such age-specific differences. High ratings of psychological problems for the elderly DS residents corresponded very well with the diagnosis of 'dementia' made by the physicians. Only for non-DS persons with severe mental retardation was a proportional decrease of challenging behaviour found with advanced age. Whereas psychological problems in elderly DS persons could be explained for the greater part of the diagnosis 'dementia', challenging behaviour--although also common in elderly DS--was shown to be a more independent phenomenon. With regard to psychiatric diagnosis, non-DS residents with mild retardation had six times as much a mental disorder, and non-DS residents with severe or profound mental retardation had up to 15 times as much, compared with their DS peers.

Adolescent↗

Elderly residents in Dutch mental deficiency institutions.

In the period 1986-1988, a cross-sectional study was carried out in 21 mental deficiency institutions in two provinces of the Netherlands. One of the key-questions of this study was whether there are differences between the younger and older adult mentally handicapped in Dutch mental deficiency institutions, in prevalences of diseases and sensory handicaps, mobility, motor skills and social functioning. In this article, some results of the study are presented.

Activities of Daily Living↗

Psychiatric foster care for adult patients: results of a study in The Netherlands.

Since the 1920s psychiatric foster care has been considered as an important alternative to psychiatric hospitalization in the Netherlands. About one percent of the mental hospital patients are actually living with contracted families. These patients have their meals with their foster families, and stay there at night and at the weekends. Foster families can obtain support from hospital staff. Day-programmes, treatment and work rehabilitation, however, are usually undertaken in the grounds of the mental hospital. Some data will be presented on the characteristics, skills, social integration and consumer satisfaction of all 188 patients staying with 162 foster families. A comparison is made with a random-sample of hospital inpatients (N = 381), patients in sheltered homes (N = 179) and in day-centres (N = 86).

Adult↗

Defining fragility of the elderly severely mentally handicapped according to mortality risk, morbidity, motor handicaps and social functioning.

The main aim of this study was to find a cut-off point in the age-distribution at which the physical fragility of the severe mentally handicapped residents increases. The following criteria for age-related fragility were used: mortality risk, morbidity rates of chronic diseases, motor problems and social functioning. The age-specific mortality risks were computed by means of data of the National Case register in the period 1978-1983. The morbidity-rates, rates of motor handicaps and handicaps of social functioning were calculated from a random sample of 550 severe mentally handicapped in 100 institutions and sheltered homes. The results of this cross-sectional study showed a high prevalence of diseases and handicaps, and a high mortality-rate until the age of 30, mainly determined by pre- and perinatal birth defects. The most healthy residents were found according to our criteria in the 30-50 year age group. A significant increase in health problems of 'the elderly' were observed only after the age of about 50 years, as indicated by a high prevalence of diseases and sensory handicaps, mortality risk, motor problems and problems with basis personal skills. The linguistic skills of elderly persons were significantly better in comparison with the younger residents.

Activities of Daily Living↗