RESUMO
BACKGROUND: Rapid spread of coronavirus disease 2019 (COVID-19) has affected people with intellectual disability disproportionately. Existing data does not provide enough information to understand factors associated with increased deaths in those with intellectual disability. Establishing who is at high risk is important in developing prevention strategies, given risk factors or comorbidities in people with intellectual disability may be different to those in the general population. AIMS: To identify comorbidities, demographic and clinical factors of those individuals with intellectual disability who have died from COVID-19. METHOD: An observational descriptive case series looking at deaths because of COVID-19 in people with intellectual disability was conducted. Along with established risk factors observed in the general population, possible specific risk factors and comorbidities in people with intellectual disability for deaths related to COVID-19 were examined. Comparisons between mild and moderate-to-profound intellectual disability subcohorts were undertaken. RESULTS: Data on 66 deaths in individuals with intellectual disability were analysed. This group was younger (mean age 64 years) compared with the age of death in the general population because of COVID-19. High rates of moderate-to-profound intellectual disability (n = 43), epilepsy (n = 29), mental illness (n = 29), dysphagia (n = 23), Down syndrome (n = 20) and dementia (n = 15) were observed. CONCLUSIONS: This is the first study exploring associations between possible risk factors and comorbidities found in COVID-19 deaths in people with intellectual disability. Our data provides insight into possible factors for deaths in people with intellectual disability. Some of the factors varied between the mild and moderate-to-profound intellectual disability groups. This highlights an urgent need for further systemic inquiry and study of the possible cumulative impact of these factors and comorbidities given the possibility of COVID-19 resurgence.
RESUMO
The literature on the effect of age on saliva production, which has implications for health, quality of life, differential diagnosis, and case management, remains inconclusive. Physiological changes, motor and sensory, are frequently reported with increasing age. It was hypothesized that there would be a change in saliva production with older age. Whole stimulated saliva was collected by asking participants to chew gauze for 1 minute and then comparing the weight of saliva produced according to age and sex. Data were collected in activity centers for older adults, workplaces, universities, and participants' homes. Five hundred forty healthy individuals (aged 20-97) in three age groups (young = 20-30; middle-aged = 40-50; older ≥ 70) participated (90 men and 90 women in each group). A decrement in saliva production was identified for age in that the young and older participants and the middle-aged and older participants differed significantly from each other, but no difference was found between the young and middle-aged participants. The main effect of sex was not significant, nor was the interaction of age and sex. The results have implications for research and clinical work, including the differential diagnosis and subsequent management of salivary flow impairment due to age or underlying medical diagnosis or treatment. The assessment tool is easily administered and inexpensive and lends itself to use in many different clinical and research settings by different professionals.
