title: Screening for cardiovascular disease risk factors at baseline and post intervention among adults with intellectual disabilities in an urbanised Asian society.
abstract: BACKGROUND
  Adults with intellectual disabilities (ID) face significant barriers to screening participation. We determined predictors for regular cardiovascular health screening at baseline among adults with ID in Singapore, and evaluated the effectiveness of a 3-month screening intervention.
  
  
  METHODS
  The study population involved all adults with ID aged ≥40 years receiving services from the Movement for the Intellectually Disabled of Singapore (MINDS), the largest such provider in Singapore. Over 3 months in 2011, adult clients not screened regularly at baseline for hypertension, diabetes and dyslipidaemia were offered free and convenient blood pressure, fasting blood glucose and lipid testing; data on other cardiovascular disease risk factors were also collected. Chi-square and logistic regression identified predictors of regular screening at baseline.
  
  
  RESULTS
  Participation was 95.0% (227/239). At baseline, among adults with ID, 61.8% (118/191), 24.8% (52/210) and 18.2% (34/187) had gone for regular hypertension, diabetes and dyslipidaemia screening respectively; post intervention, rates rose to 96.9%, 89.5% and 88.8% respectively. Prevalence of cardiovascular disease risk factors (22.5% with hypertension, 10.6% with diabetes, 34.8% with dyslipidaemia, 10.7% obese and 90.6% lacking regular exercise) was high compared against the general population. While receiving residential services was associated with regular hypertension screening, receiving non-residential services and being independently mobile were associated with regular participation in fasting blood tests (all P < 0.05).
  
  
  CONCLUSIONS
  Cardiovascular disease risk factors are common among adults with ID and clinicians should proactively screen such populations. Provision of free and convenient screening for cardiovascular disease risk improved screening participation.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
authors.forename: L E
authors.initials: LE
authors.lastname: Wee
authors.forename: G C-H
authors.initials: GC
authors.lastname: Koh
authors.forename: L S
authors.initials: LS
authors.lastname: Auyong
authors.forename: A
authors.initials: A
authors.lastname: Cheong
authors.forename: T T
authors.initials: TT
authors.lastname: Myo
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.forename: E
authors.initials: E
authors.lastname: Lim
authors.forename: S
authors.initials: S
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Sundaramurthy
authors.forename: C W
authors.initials: CW
authors.lastname: Koh
authors.forename: P
authors.initials: P
authors.lastname: Ramakrishnan
authors.forename: R
authors.initials: R
authors.lastname: Aariyapillai-Rajagopal
authors.forename: H
authors.initials: H
authors.lastname: Vaidynathan-Selvamuthu
authors.forename: K
authors.initials: K
authors.lastname: Ma-Ma
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006293:Health Promotion; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000458:organization & administration / Q000592:standards*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D014505:Urban Population
keywords: diabetes; dyslipidaemia; health screening; hypertension; intellectual disabilities