Health checks for adults with intellectual disability and association with survival rates: A linked electronic records matched cohort study in Wales, UK

Abstract

Objective To examine if mortality rates are lower in people with intellectual disability who have had a health check compared with those who have not had health checks. Setting General practice records of 26 954 people with an intellectual disability in Wales between 2005-2017, of which 7650 (28.4%) with a health check were matched 1:2 with those without a health check. Primary outcome measure Office of National Statistics mortality data; a Cox regression was utilised to examine time to death adjusted for comorbidities and gender. Results Patients who had a health check were stratified by those who (1) had a confirmed health check, that is, Read Code for a health check (n=7650 (28.4 %)) and (2) had no evidence of receiving a health check in their medical record. Patients with a health check were matched for age at time of health check with two people who did not have a health check. The health check was associated with improved survival for those with autism or Down's Syndrome (HR 0.58 (95% CI 0.37 to 0.91) and HR 0.76 (95% CI 0.64 to 0.91), respectively). There was no evidence of improved survival for those diagnosed with diabetes or cancer. The people who had a health check were more likely to be older, have epilepsy and less likely to have autism or Down's syndrome. Conclusions Health checks are likely to influence survival if started before a person is diagnosed with a chronic condition, especially for people with autism or Down's syndrome.