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Higher covid mortality among people with intellectual disabilities

21 Apr 2023

People with intellectual disabilities have a higher risk of dying from the Covid-19 virus compared to the rest of the population. That is what researchers of the Radboudumc conclude. The researchers hope that their study raises awareness about the vulnerability of people with intellectual disabilities.

The researchers have compared the first two years of the Covid-19 pandemic to the five years before the start of the pandemic to investigate the difference in mortality rates between people with and without intellectual disabilities. The study indicates that the covid mortality rate for people with intellectual disabilities is four times higher compared to rest the rest of the population.

Higher risks

People with intellectual disabilities generally have a higher mortality rate compared to the rest of the population, but this rate has increased considerably during the pandemic, says epidemiologist and Radboudumc researcher Maarten Cuypers. There are several reasons for this. ‘The cause of the disabilities is often also the cause of physical problems, which makes them physically more vulnerable. When they get infected with corona, their immune system responds less effectively compared to physically healthy people.’

On top of that, people with intellectual disabilities also have a higher chance of catching the virus, Cuypers adds. ‘This group often requires a lot of assistance and care. They live in assisted living groups or go to day care. All these different contacts lead to lots of infection routes.’ In addition, intellectual disability can also give rise to difficulties in following the covid measures. ‘For instance, try to explain to someone with a intellectual disability why and when to wear a face mask.’

Higher cancer mortality

The increased covid mortality alone cannot fully explain the overall mortality. Dying rates because of cancer, neurological disorders, and external causes (such as falling) have also shown a sharp increase during the pandemic amongst people with intellectual disabilities compared to the rest of the population.

According to Cuypers, this can partly be explained by the lack of specific knowledge. ‘For example, diabetes is common amongst people with intellectual disabilities, and a covid infection can severely worsen the symptoms. Yet, for diabetic patients without intellectual disabilities that doesn’t necessarily have to be the case. These additional health risks are not always known to healthcare professionals.’

Lack of care

Furthermore, in times of crisis, regular care becomes less available, which automatically affects vulnerable groups more severely. ‘People also became more vigilant about visiting the GP because of the potential risk of infection. Physical deterioration then often is not timely noticed, which can result in more serious complications.’ Cuypers also recognised this during the flu epidemic in 2017-2018. ‘During that time there was a higher mortality rate due to the flu, but other external factors were also at play.’

‘We cannot eliminate the vulnerability’

Cuypers hopes that the study contributes to more awareness about the vulnerability of people with intellectual disabilities. Both in clinical practice and in public health policies. ‘We cannot eliminate the vulnerability. Whether we like it or not, the virus is here and we cannot fully prevent the infection routes.’

The researcher therefore stresses the importance of people being aware of the health risks of this group, so that people can more effectively respond to their different care needs. ‘It is also important that better monitoring of this group is established. For instance, it is difficult to create policies considering a vulnerable group, when that group is hardly in sight.’

Translated by Sophie Verhoeven

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