Major health risks in aging persons with intellectual disabilities: An overview of recent studies

Journal of Policy and Practice in Intellectual Disabilities

Volumn 7, Issue 1, 2010, Pages 59-69

  Haveman, Meindert ^a   Heller, Tamar ^b   Lee, Lynette ^c   Maaskant, Marian ^d   Shooshtari, Shahin ^e   Strydom, Andre ^f  

^a TU DORTMUND UNIVERSITY   (Germany)

^b UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

^c Department of Geriatric Medicine   (Australia)

^d MAASTRICHT UNIVERSITY   (Netherlands)

^e UNIVERSITY OF MANITOBA   (Canada)

^f UNIVERSITY COLLEGE LONDON   (United Kingdom)

Author keywords

Aging; Health risks; Health status; Intellectual disabilities

Indexed keywords

EID: 77954369803     PISSN: 17411122     EISSN: 17411130     Source Type: Journal    
DOI: 10.1111/j.1741-1130.2010.00248.x     Document Type: Review

References (145)

1. van den Akker M, Buntinx F, Metsemakers J F, Roos S, Knottnerus J A. Multimorbidity in general practice: Prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. Journal of Clinical Epidemiology 1998, 51:367-375.
2. van den Akker M, Maaskant M A, van der Meijden R J. Cardiac diseases in people with intellectual disability. Journal of Intellectual Disability Research 2006, 50:515-522.
3. Angelopoulou N, Matziari C, Tsimaras V, Sakadamis A, Souftas V, Mandroukas K. Bone mineral density and muscle strength in young men with mental retardation (with and without Down syndrome). Calcified Tissue International 2000, 66:176-180.
4. Beange H, Lennox N. Physical aspects of health in the learning disabled. Current Opinion in Psychiatry 1998, 11:531-534.
5. Bertoli S, Battezzati A, Merati G, Margonato V, Maggioni M, Testolin G. Nutritional status and dietary patterns in disabled people. Nutrition, Metabolism & Cardiovascular Diseases 2006, 16:100-112.
6. Bhaumik S, Watson J, Thorp C, Tyrer F, McGrother C. Body mass index in adults with intellectual disability: Distribution, associations and service implications: A population-based prevalence study. Journal of Intellectual Disability Research 2008, 52:287-298.
7. Bittles A H, Petterson B A, Sullivan S G, Hussain R, Glasson E J, Montgomery P D. The influence of intellectual disability on life expectancy. Journal of Gerontology 2002, 57:M470-M472.
8. Böhmer C J, Klinkenberg-Knol E C, Kuipers E J, Niezen-de Boer M C, Schreuder H, Schuckink-Kool F. The prevalence of Helicobacter pylori infection among inhabitants and healthy employees of institutes for the intellectually disabled. American Journal of Gastroenterology 1997, 92:1000-1004.
9. Böhmer C, Niezen-de Boer M, Klinkenberg-Knol E, Deville W, Nadorp J, Meuwissen S. The prevalence of gastro-oesophageal reflux disease in institutionalised intellectually disabled individuals. American Journal of Gastroenterology 1999, 94:804-810.
10. Böhmer C, Niezen-de Boer M, Klinkenberg-Knol E, Meuwissen S. Review article. Gastroesophageal reflux disease in intellectually disabled individuals: How often, how serious, how manageable? American Journal of Gastroenterology 2000, 95:1868-1872.
11. Böhmer C J, Taminiau J A, Klinkenberg-Knol E C, Meuwissen S G. The prevalence of constipation in institutionalized people with intellectual disability. Journal of Intellectual Disability Research 2001, 45:212-218.
12. Bradley C, McAllister T. The oral health of children with Down syndrome in Ireland. Special Care Dentistry 2004, 24:55-60.
13. Braunschweig C, Gomez S, Sheean P, Tomey K, Rimmer J, Heller T. Nutritional status and risk factors for chronic disease in urban-dwelling adults with Down syndrome. American Journal on Mental Retardation 2004, 109:186-193.
14. Center J, Beange H, McEjduff A. People with mental retardation have an increased prevalence of osteoporosis: A population study. American Journal of Mental Retardation 1998, 103:19-28.
15. Clarke D, Vermuri M, Gunatilake D, Tewari S. Brief report. Helicobacter pylori infection in five inpatient units for people with intellectual disability and psychiatric disorder. Journal of Applied Research in Intellectual Disabilities 2008, 21:95-98.
16. Cooper S A. Clinical study of the effects of age on the physical health of adults with mental retardation. American Journal of Mental Retardation 1998, 102:582-589.
17. Corbin S, Malina K, Shepherd S. Special olympics world summer games 2003: healthy athletes screening data 2005, Washington, DC, Special Olympics, Inc
18. Cumella S, Ransford N, Lyons J, Burnham H. Needs for oral care among people with intellectual disability not in contact with community dental services. Journal of Intellectual Disability Research 2000, 44:45-52.
19. Day S M, Strauss D J, Shavelle R M, Reynolds R J. Mortality and causes of death in persons with Down syndrome in California. Developmental Medicine and Child Neurology 2005, 47:171-176.
20. Draheim C C. Cardiovascular disease prevalence and risk factors of persons with mental retardation. Mental Retardation and Developmental Disabilities Research Reviews 2006, 12:3-12.
21. Draheim C C, Williams D P, McCubbin J A. Physical activity, dietary intake, and the insulin resistance syndrome in nondiabetic adults with mental retardation. American Journal on Mental Retardation 2002a, 107:361-375.
22. Draheim C C, Williams D P, McCubbin J A. Prevalence of physical inactivity and recommended physical activity in community-based adults with mental retardation. Mental Retardation 2002b, 40:436-444.
23. Draheim C C, McCubbin J A, Williams D P. Differences in cardiovascular disease risk between nondiabetic adults with mental retardation with and without Down syndrome. American Journal on Mental Retardation 2002c, 107:201-211.
24. Draheim C C, Williams D P, McCubbin J A. Cardiovascular disease risk factor differences between Special Olympians and non-Special Olympians. Adapted Physical Activity Quarterly 2003, 20:118-134.
25. Draheim C C, Stanish H I, Williams D P, McCubbin J A. Dietary intake of adults with mental retardation who reside in community settings. American Journal on Mental Retardation 2007, 112:392-400.
26. Duff M, Scheepers M, Cooper M, Hoghton M, Baddeley P. Helicobacter pylori: Has the killer escaped from the institution? A possible cause of increased stomach cancer in a population with intellectual disability. Journal of Intellectual Disability Research 2001, 45:219-225.
27. Emerson E. Underweight, obesity and exercise among adults with intellectual disabilities in supported accommodation in Northern England. Journal of Intellectual Disability Research 2005, 49:134-143.
28. Esbensen A, Seltzer M, Greenberg J. Factors predicting mortality in midlife adults with and without Down syndrome living with family. Journal of Intellectual Disability Research 2007, 51:1039-1050.
29. Evenhuis H M. Medical aspects of ageing in a population with intellectual disability: III. mobility, internal conditions and cancer. Journal of Intellectual Disability Research 1997, 41:8-18.
30. Evenhuis H, Henderson C M, Beange H, Lennox N, Chicoine B. Healthy ageing-Adults with intellectual disabilities: Physical health issues 2001, Geneva, Switzerland, World Health Organization
31. Fernhall B, Pitetti K H. Limitations to physical work capacity in individuals with mental retardation. Clinical Exercise Physiology 2001, 3:176-185.
32. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Annals of Family Medicine 2005, 3:223-228.
33. Frey G. Comparison of physical activity levels between adults with and without mental retardation. Journal of Physical Activity and Health 2004, 1:235-245.
34. Fujiura G T, Yamaki K. Analysis of ethnic variations in developmental disability prevalence and household economic status. Mental Retardation 1997, 35:268-294.
35. Gale L, Naqvi H, Russ L. Asthma, smoking and BMI in adults with intellectual disabilities: A community-based survey. Journal of Intellectual Disabilities Research 2009, 53:787-796.
36. Geerts S O, Legrand V, Charpentier J, Albert A, Rompen E. Further evidence of the association between periodontal conditions and coronary artery disease. Journal of Periodontology 2004, 75:1274-1280.
37. Glick N R, Fischer H M, Heisey M D, Leverson E G, Mann C D. Epidemiology of fractures in people with severe and profound developmental disabilities. Osteoporosis International 2005, 16:389-396.
38. Goodwin C, Mendall M, Northfield T. Helicobacter pylori infection. Lancet 1997, 349:265-269.
39. Graham A, Reid G. Physical fitness of adults with an intellectual disabilitiy: A 13-years follow-up study. Research Quarterly for Exercise and Sport 2000, 71:152-161.
40. Gravestock S. Eating disorders in adults with intellectual disability. Journal of Intellectual Disability Research 2000, 44:625-637.
41. Guijarro M, Valero C, Paule B, Gonzales-Macias J, Riancho J. Bone mass in young adults with Down syndrome. Journal of Intellectual Disability Research 2008, 52:182-189.
42. Harris J. Time to make up your mind: Why choosing is difficult. British Journal of Learning Disability 2003, 31:3-8.
43. Haslam D W, James W P. Obesity. Lancet 2005, 366:1197-1209.
44. Haslam D, Sattar N, Lean M. ABC of obesity. Obesity-Time to wake up. British Medical Journal 2006, 333:640-642.
45. Haveman M J. Disease epidemiology and aging people with intellectual disabilities. Journal of Policy and Practice in Intellectual Disabilities 2004, 1:16-23.
46. Haveman M J, Heller T, Lee L A, Maaskant M A, Shooshtari S, Strydom A. Report on the state of science on health risks and ageing in people with intellectual disabilities 2009, Dormund, Germany, University of Dormund (Faculty of Rehabilitation Sciences)
47. Heller T, Hsieh K, Rimmer J. Attitudinal and psychosocial outcomes of a fitness and health education program on adults with Down syndrome. American Journal on Mental Retardation 2004, 109:175-185.
48. Henderson C M, Robinson L M, Davidson P, Haveman M, Janicki M P, Albertini G. Overweight status, obesity and risk factors for coronary heart disease in adults with Intellectual Disability. Journal of Policy and Practice in Intellectual Disabilities 2008, 5:174-177.
49. Hennequin M, Allison P J, Veyune J L. Prevalence of oral health problems in a group of individuals with Down syndrome in France. Developmental Medicine & Child Neurology 2000, 42:691-698.
50. Hill D A, Gridley G, Cnattingius S, Mellemkjaer L, Linet M, Adami H -O. Mortality and cancer incidence among individuals with Down syndrome. Archives of Internal Medicine 2003, 163:705-711.
51. Horwitz S M, Kerker B D, Owens P L, Zigler E. The health status and needs of individuals with mental retardation 2000, Washington, DC, Special Olympics, Inc.
52. Hove O. Weight survey on adult persons with mental retardation living in the community. Research in Developmental Disabilities 2004, 25:9-17.
53. GI disorders in adults: Gastroesophageal reflux disease. 2003, http://www.iffgd.org/GIDisorders/GIAdults.htm, International Foundation for Functional Gastrointestinal Disorders, Inc. (IFFGD), Retrieved on October 27, 2009, from
54. Janicki M P, Dalton A J, Henderson C, Davidson P. Mortality and morbidity among older adults with intellectual disability: Health services considerations. Disability and Rehabilitation 1999, 21:284-294.
55. Janicki M P, Davidson P W, Henderson C M, McCallion P, Taets J D, Force L T. Health characteristics and health services utilization in older adults with intellectual disability living in community residences. Journal of Intellectual Disability Research 2002, 46:287-298.
56. Kapell D, Nightingale B, Rodriguez A, Lee J, Zigman W, Schupf N. Prevalence of chronic medical conditions in adults with mental retardation: Comparison with the general population. Mental Retardation 1998, 36:269-279.
57. Kennedy C. Screening for Helicobacter pylori in adults with developmental disabilities-Prevalence of infection and testing considerations for urea breath test, serology and whole-blood methods. 2002, Unpublished master's thesis, Queen's University, Kingston, Ontario, Canada
58. Kerr A M, McCulloch D, Oliver K, McLean B, Coleman E, Law T. Medical needs of people with intellectual disability require regular assessment, and the provision of client- and carer-held reports. Journal of Intellectual Disability Research 2003, 47:134-145.
59. van Knijff-Raeven A G M, Jansen-Jacobs C C M, Freens P J W, Hoekman J, Maaskant M A. Body Mass Index (BMI) bij mensen met verstandelijke beperkingen [Body Mass index (BMI) of people with intellectual restrictions]. Nederlands Tijdschrift voor de Zorg aan verstandelijk gehandicapten (Dutch Journal for Care to Persons with Intellectual Diusabilities) 2005, 31:3-17.
60. van Knijff-Raeven A G M, Hartong S P, Maaskant M A, Akker M. Veranderingen in de gewichtsstatus van mensen met verstandelijke beperkingen [Changes in the weight status of people with intellectual disabilities]. Nederlands Tijdschrift voor de Zorg aan verstandelijk gehandicapten (Dutch Journal for Care to Persons with Intellectual Disabilities) 2006, 32:230-239.
61. Lader D, Chadwick B, Chestnutt I. Children's dental health in the United Kingdom, 2003 2005, http://www.statistics.gov.uk/CHILDREN/dentalhealth/down-loads/cdh_Summary.pdf, London, Office of National Statistics, Available at:
62. Lembo A, Cammilleri M. Chronic constipation. New England Journal of Medicine 2003, 349:1360-1368.
63. Lewis M A, Lewis C E, Leake B, King B, Lindemann R. The quality of health care for adults with developmental disabilities. Public Health Reports 2002, 117:174-184.
64. Lindeman A K. Resident manager's nutritional concerns for staff and residents of group homes for mentally retarded adults. Journal of the American Dietetic Association 1991, 91:602-604.
65. Lohiya G S, Crinella F M, Tan-Figueroa L, Caires S, Lohiya S. Fracture epidemiology and control in a developmental center. Western Journal of Medicine 1999, 170:203-209.
66. Lopez-Perez R, Borges-Yanes S, Jimenez-Garcia G, Maupome G. Oral hygiene, gingivitis, and periodontitis in persons with Down syndrome. Special Care Dentistry 2002, 22:214-220.
67. Lunsky Y, Straiko A, Armstrong S. Women be healthy: Evaluation of a women's health curriculum for women with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities 2005, 16:247-253.
68. Maaskant M, Gevers J, Wierda H. Mortality and life expectancy in Dutch residential centres for individuals with intellectual disability, 1991-1995. Journal of Applied Research in Intellectual Disability 2002, 15:200-212.
69. Maaskant M A, van Knijff-Raeven A G M, van Schrojenstein Lantman-de Valk H M J, Veenstra M Y. Weight status of persons with intellectual disabilities. 2009, Unpublished manuscript, University of Maastricht
70. Mann J, Zhou H, McDermott S, Poston M B. Healthy behavior change of adults with mental retardation: Attendance in a health promotion program. American Journal on Mental Retardation 2006, 111:62-73.
71. Marks B, Sisirak J, Heller T. Health Matters: The Exercise and Nutrition Health Education Curriculum for People with Developmental Disabilities 2010, Baltimore, Brookes Publishing
72. Marshall D, McConkey R, Moore G. Obesity in people with intellectual disabilities: The impact of nurse-led health screenings and health promotion activities. Journal of Advanced Nursing 2003, 41:147-153.
73. McDermott S, Platt T, Krishnaswami S. Are individuals with mental retardation at high risk for chronic disease? Family Medicine 1997, 29:429-434.
74. McGuire B E, Daly P, Smyth F. Lifestyle and health behaviours of adults with an intellectual disability. Journal of Intellectual Disability Research 2007, 51:497-510.
75. Melville C A, Cooper S -A, McGrother C W, Thorp C F, Collacott R. Obesity in adults with Down syndrome: A case-control study. Journal of Intellectual Disability Research 2005, 49:125-133.
76. Mercer K, Ekvall S. Comparing the diets of adults with mental retardation who live in intermediate care facilities and in group homes. Journal of the American Dietetic Association 1992, 92:356-358.
77. Merrick J, Davidson P W, Morad M, Janicki M P, Wexler O, Henderson C M. Older adults with intellectual disability in residential care centers in Israel: Health status and service utilization. American Journal on Mental Retardation 2004, 109:413-420.
78. Messent P R, Cooke C B, Long J. Physical activity, exercise and health of adults with mild and moderate learning disabilities. British Journal of Learning Disabilities 1998, 26:17-22.
79. Miller J, Kranzler J, Liu Y, Schmalfuss I, Theriaque D W, Shuster J J. Neurocognitive findings in Prader-Willi syndrome and early-onset morbid obesity. Journal of Pediatrics 2006, 149:192-198.
80. Morad M, Merrick J, Nasri Y. Prevalence of Helicobacter pylori infection in people with intellectual disabilities in a residential care center in Israel. Journal of Intellectual Disability Research 2002, 46:141-143.
81. Morad M, Nelson N, Merrick J, Davidson P W, Carmeli E. Prevalence and risk factors of constipation in adults with intellectual disability in residential care centers in Israel. Research in Developmental Disabilities 2007, 28:580-586.
82. Moran R, Drane W, McDermott S, Dasari S, Scurry J, Platt T. Obesity among people with and without mental retardation across adulthood. Obesity Research 2005, 13:342-349.
83. Mugica I, Ansa J, Sistiaga F, Zabalza R, Zubillaga P, Merino A. Digital computerized absorptiometry in the diagnosis of osteoporosis in a group of the severely mentally retarded. Nutricion Hospitalaria 2002, 17:213-218.
84. Tackling obesity in England 2001, National Audit Office, Report by the Comptroller and Auditor General, London, Her Majesty's Stationary Office
85. Practical oral care for people with intellectual disability. 2009, http://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/PracticalOralCarePeopleIntellectualDisability.htm, National Institute of Dental and Craniofacial Research (NIDCR), Retrieved on January 31, 2010, from
86. Tobacco cessation resource materials for people with intellectual disabilities. http://www.ndcpd.org/health/files/publications/tob%20cess%20info%201-09.pdf, North Dakota Disability Health Project, n.d, Retrieved November 8, 2009, from
87. O'Brien G. Behavioural phenotypes in adulthood. 2008, http://www.intellectualdisability.info/mental_phys_health/P_phenotypes_go.html, Retrieved October 23, 2008, from
88. Owens P L, Kerker B D, Zigler E, Horwitz S M. Vision and oral health needs of individuals with intellectual disability. Mental Retardation and Developmental Disabilities Research Reviews 2006, 12:28-40.
89. Patja K, Molsa P, Iivanainen M. Cause-specific mortality of people with intellectual disability in a population-based, 35-year follow-up study. Journal of Intellectual Disability Research 2001, 45:30-40.
90. Podgorsky C, Kessler K, Cacia B, Peterson D, Henderson M. Physical activity intervention for older adults with intellectual disability: Report on a pilot project. Mental Retardation 2004, 42:272-283.
91. Pregliasco F, Ottolina P, Mensi C, Carmagnola D, Giussani F, Abati S. Oral health profile in an institutionalized population of Italian adults with mental retardation. Special Care Dentistry 2001, 21:227-231.
92. Rao D B, Hegde A M, Munshi A K. Caries prevalence amongst handicapped children of South Canara district, Karnataka. Journal of Indian Society of Pedodontics and Preventive Dentistry 2001, 19:67-73.
93. Rimmer J H, Braddock D, Fujiura G. Cardiovascular risk factors in adults with mental retardation. American Journal of Mental Retardation 1994, 98:510-518.
94. Rimmer J H, Heller T, Wang E, Valerio I. Improvements in physical fitness in adults with Down syndrome. American Journal on Mental Retardation 2004, 109:165-174.
95. Rimmer J H, Wang E. Obesity prevalence among a group of Chicago residents with disabilities. Archives of Physical Medicine and Rehabilitation 2005, 86:1461-1464.
96. Rimmer J H, Yamaki K. Obesity and intellectual disability. Mental Retardation and Developmental Disabilities Research Reviews 2006, 12:22-27.
97. Robertson J, Emerson E, Gregory N, Hatton C, Turner S, Kessissoglou S. Lifestyle related factors for poor health in residential settings for people with intellectual disabilities. Research in Developmental Disabilities 2000, 21:469-486.
98. Rodríguez-Vázquez C, Garcillan M R, Rioboo R, Bratos E. Prevalence of dental caries in an adult population with mental disabilities in Spain. Special Care Dentistry 2002, 22:65-69.
99. Rubin S, Rimmer J, Chicoine B, Braddock D, McGuire D. Overweight prevalence in persons with Down syndrome. Mental Retardation 1998, 36:175-181.
100. Schrager S. Osteoporosis in women with disabilities. Journal of Women's Health 2004, 13:431-437.
101. Schrager S. Epidemiology of osteoporosis in women with cognitive impairment. Mental Retardation 2006, 44:203-211.
102. van Schrojenstein Lantman-de Valk H M, Metsemakers J F, Haveman M J, Crebolder H F. Health problems in people with intellectual disability in general practice: A comparative study. Family Practice 2000, 17:405-407.
103. van Schrojenstein Lantman-de Valk H M. Health in people with intellectual disabilities: Current knowledge and gaps in knowledge. Journal of Applied Research in Intellectual Disabilities 2005, 18:325-333.
104. Shapira J, Efrat J, Berkey D, Mann J. Dental health profile of a population with mental retardation in Israel. Special Care Dentistry 1998, 18:149-155.
105. Shrestha S, Weber G. The situation of older people with intellectual disability in Nepal: A pilot study. Journal of Intellectual and Developmental Disability 2002, 27:242-254.
106. Skyama M, Al-Mutawa S A, Morris R E, Sugathan T, Honkala E. Dental caries experience of disabled children and young adults in Kuwait. Community Dental Health 2001, 18:181-186.
107. Stanish H, Draheim C. Assessment of walking activity using a pedometer and survey in adults with mental retardation. Adapted Physical Activity Quarterly 2005a, 22:136-145.
108. Stanish H, Draheim C. Walking habits of adults with mental retardation. Mental Retardation 2005b, 43:421-427.
109. Stanish H, Draheim C. Physical activity assessment using pedometer and questionnaire in adults with mental retardation. Adapted Physical Activity Quarterly 2005c, 22:136-145.
110. Stanish H, Temple V, Frey G. Health-promoting physical activity of adults with mental retardation. Mental Retardation and Developmental Disabilities Research Reviews 2006, 12:13-21.
111. Starr J M, Taylor M D, Hart C L, Davey Smith G, Whalley L J, Hole D J, Wilson V, Deary I J. Childhood mental ability and blood pressure at midlife: linking the Scottish Mental Survey 1932 and the Midspan studies. Journal of Hypertension 2004, 22:893-898.
112. Steinberg M L, Heimlich L, Williams J M. Tobacco use among individuals with intellectual or developmental disabilities: A brief review. Intellectual and Developmental Disabilities 2009, 47:197-207.
113. Stoyanova A P. Measuring inequalities in dental health and dental care utilisation: Evidence from Spain 2003, http://riscd2.eco.ub.es/~creb/papers/DentIneq.pdf, Barcelona, Universitat de Barcelona, Retrieved November 8, 2009, from
114. Strauss D, Kastner T, Shavelle R. Mortality of adults with developmental disabilities living in California institutions and community care, 1985-1994. Mental Retardation 1998, 36:360-371.
115. Sutherland G, Couch M A, Iacono T. Health issues for adults with developmental disability. Research in Developmental Disabilities 2002, 23:422-445.
116. Talley N, Jones M, Nuyts G, Dubois G. Risk factors for chronic constipation based on a general practice sample. American Journal of Gastroenterology 2003, 98:1107-1111.
117. Temple V. Physical activity levels of individuals living in a group home. Journal of Intellectual and Developmental Disabilities 2000, 25:327-341.
118. Temple V A, Walkley J W. Physical activity of adults with intellectual disability. Journal of Intellectual and Developmental Disabilities 2003a, 28:323-334.
119. Temple V A, Walkley J W. Living arrangements and training influences on participation in physical activity among intellectually disabled adults. Medicine & Science in Sports & Exercise 2003b, 35:S66.
120. Traci M, Seekins T, Szalda-Petree A, Ravesloot C. Assessing secondary conditions among adults with developmental disabilities: A preliminary study. Mental Retardation 2002, 40:119-131.
121. Tracy J, Wallace R. Presentations of physical illness in people with developmental disability: The example of gastroesophageal reflux. Medical Journal of Australia 2001, 175:109-111.
122. Tsimaras V, Giagazoglou P, Fotiadou E, Christoulas K, Angelopoulou N. Jog-walk training in cardiorespiratory fitness of adults with Down syndrome. Perception and Motor Skills 2003, 96:1239-1251.
123. Turner S, Sweeney M, Kennedy C, Macpherson L. The oral health of people with intellectual disability participating in the UK Special Olympics. Journal of Intellectual Disability Research 2008, 1:29-36.
124. Tyler C, Snyder C, Zyzansky S. Screening for osteoporosis in community-dwelling adults with mental retardation. Mental Retardation 2000, 38:316-321.
125. Closing the gap: A national blueprint to improve the health of persons with mental retardation-Report of the Surgeon General's Conference on Health Disparities and Mental Retardation 2002, U.S. Surgeon General, Rockville, MD, Author
126. Healthy people 2010 2000, U.S. Department of Health and Human Services (USDHHS), 2nd, ed.). With understanding and improving health and objectives for improving health. 2 vols, Washington, DC, U.S. Government Printing Office
127. Varela A, Sardinha L, Pitetti K. Effects of an aerobic rowing training regimen in young adults with Down syndrome. American Journal of Mental Retardation 2001, 106:135-144.
128. Vonken M T H, Maaskant M A, van den Akker M. Aandoeningen van het bewegingsapparaat bij mensen met een verstandelijke handicap [Disorders of the movement system of people with intellectual disability]. Nederlands Tijdschrift voor de Zorg aan verstandelijk gehandicapten (Dutch Journal for Care to Persons with Intellectual Disabilities) 2006, 32:98-111.
129. Vyse A J, Gay N J, Hesketh L M, Andrews N J, Marshall B, Thomas P, Morgan-Capner P, Miller E. The burden of Helicobacter pylori infection in England and Wales. Epidemiological Infections 2002, 128:411-417.
130. Waldman H B, Perlman S P. Oral health, nurses and patients with developmental disabilities. International Journal of Nursing in Intellectual and Developmental Disabilities 2009, 3:4.
131. Waldman H, Perlman S, Swerdloff M. Dental care for children with mental retardation: Thoughts about the Americans with Disabilities Act. Journal of Dentistry for Children 1998, 65:487-491.
132. Wallace R, Schluter P. Audit of cardiovascular disease risk factors among supported adults with intellectual disability attending an ageing clinic. Journal of Intellectual and Developmental Disability 2008, 33:48-58.
133. Wallace R, Schluter P, Webb P. Environmental, medical behavioural and disability factors associated with Helicobacter pylori infection in adults with intellectual disability. Journal of Intellectual Disability Research 2002, 46:51-60.
134. Wallace R, Schluter P, Webb P. Recurrence of Helicobacter pylori infection in adults with intellectual disability. Internal Medicine Journal 2004, 34:132-133.
135. Walsh P N. Health indicators and intellectual disability. Current Opinion in Psychiatry 2008, 21:474-478.
136. Walsh P N, Kerr M, van Schrojenstein Lantman-DeValk H M J. Health indicators for people with intellectual disability: A European perspective. European Journal of Public Health 2003, 13:47-50.
137. Wang K Y, Hsieh K, Davidson P W, Janicki M P. Carer reports of health status among adults with intellectual/developmental disabilities in Taiwan living at home and in institutions. Journal of Intellectual Disability Research 2007, 51:173-183.
138. Wilkinson J E, Culpepper L, Cerreto M. Screening tests for adults with intellectual disabilities. Journal of the American Board of Family Medicine 2007, 20:399-407.
139. van Winckel M, van de Keere N, Deblare S, van Put V, Robberecht E. Use of laxatives in institutions for the mentally retarded. European Journal of Clinical Pharmacology 1999, 54:965-969.
140. Data and statistics: Country classification. 2009, http://go.worldbank.org/K2CKM78CC0, World Bank, Retrieved November 7, 2009, from
141. Healthy ageing-Adults with intellectual disabilities: Summative report 2000, World Health Organization (WHO), WHO/MSD/HPS/MDP/00.3, Geneva, Switzerland, Author
142. Global strategy on diet, physical activity and health 2003, World Health Organization (WHO), Geneva, Switzerland, Author
143. Yamaki K. Body weight status among adults with intellectual disability in the community. Mental Retardation 2005, 43:1-10.
144. Yamaki K, Fujiura G T. Employment and oncome status of adults with developmental disabilities living in the community. Mental Retardation 2002, 40:132-141.
145. Zigmond M, Stabholz A, Shapira J, Bachrach G, Chaushu G, Becker A. The outcome of a preventive dental care programme on the prevalence of localized aggressive periodontitis in Down's syndrome individuals. Journal of Intellectual Disability Research 2006, 50:492-500.