title: Physical health issues in adults with severe or profound intellectual and motor disabilities: a systematic review of cross-sectional studies.
abstract: People with severe or profound intellectual and motor disabilities (SPIMD) encounter several risk factors associated with higher mortality rates. They are also likely to experience a cluster of health problems related to the severe brain damage/dysfunction. In order to earlier detect physical health problems in people with SPIMD, first of all, knowledge regarding the prevalence of physical health problems is necessary. The aim of this systematic review was to methodically review cross-sectional studies on the prevalence of various types of physical health problems in adults with SPIMD.
  
  
  
  MedLine/PubMed, CINAHL, Embase, PsycINFO and Web of Science were searched for studies published between 2004 and 2015. The quality of the incorporated studies was assessed utilising an adjusted 'risk of bias tool' for cross-sectional studies. To estimate the prevalence of the health problems, the proportion and corresponding confidence interval were calculated. A random effect meta-analysis was performed when at least three studies on a specific health problem were available.
  
  
  
  In total, 20 studies were included and analysed. In the meta-analysis, a homogeneous prevalence rate of 70% (CI 65-75%) was determined for epilepsy. Heterogeneous results were ascertained in the meta-analysis for pulmonary/respiratory problems, hearing problems, dysphagia, reflux disease and visual problems. For the health problems identified in two studies or in a single study, the degree of evidence was low. As expected, higher prevalence rates were found in the current review compared with people with ID for visual problems, epilepsy and spasticity.
  
  
  
  This review provides an overview of the current state of the art research on the prevalence of health problems in adults with SPIMD. There is a substantial need for comprehensive epidemiological data in order to find clusters of health problems specific for people with SPIMD. This would provide insight into the excess morbidity associated with SPIMD.
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
authors.forename: E A
authors.initials: EA
authors.lastname: van Timmeren
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.|Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: C P
authors.initials: CP
authors.lastname: van der Schans
authors.affiliation: Department of Special Needs Education and Youth Care, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands.
authors.forename: A A J
authors.initials: AA
authors.lastname: van der Putten
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
authors.forename: W P
authors.initials: WP
authors.lastname: Krijnen
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
authors.forename: H A
authors.initials: HA
authors.lastname: Steenbergen
authors.affiliation: Department of Primary and Community Health Care, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: H M J
authors.initials: HM
authors.lastname: van Schrojenstein Lantman-de Valk
authors.affiliation: Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Waninge
mesh_terms: D015897:Comorbidity; D004827:Epilepsy / Q000453:epidemiology*; D006304:Health Status; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D000068079:Motor Disorders / Q000453:epidemiology*; D009128:Muscle Spasticity / Q000453:epidemiology*; D014786:Vision Disorders / Q000453:epidemiology*
keywords: adults; physical health; review; severe or profound intellectual and motor disabilities; severe or profound intellectual disabilities