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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00617

Comorbidity burden in adults with autism spectrum disorders and intellectual disabilities – A report from the EFAAR (Frailty Assessment in Ageing Adults with Autism Spectrum and Intellectual Disabilities) study

 stéphanie Miot1, 2, 3*,  Tasnime AKBARALY1, 4, 5,  cecile michelon1, sylvie couderc1, crépiat sophie1, loubesac julie1, picot marie-christine2, 6, pernon éric1, gonnier véronique1, jeandel claude3,  Hubert Blain3 and baghdadli amaria1
  • 1Centre de Ressources Autisme Languedoc-Roussillon, France
  • 2INSERM U1178 Santé Mentale et Santé Publique, France
  • 3Centre de Gérontologie, Clinique Antonin Balmès, France
  • 4INSERM U1198 Mécanismes Moléculaires dans les Démences Neurodégénératives, France
  • 5Institute of Epidemiology and Health Care, Faculty of Population Health Sciences, University College London, United Kingdom
  • 6Centre Hospitalier Universitaire de Montpellier, France

Background:
Autism spectrum disorder (ASD) is an early-onset and lifelong neurodevelopmental condition frequently associated with intellectual disability (ID). Although emerging studies suggest that ASD is associated with premature ageing and various medical comorbidities, as described for ID, data are scarce.
Objectives:
To determine the comorbidity burden and its association with distinct clinical presentation in terms of ASD severity, adaptive skills, level of autonomy, and drug exposure in a well-phenotyped sample of individuals with ASD-ID – the EFAAR cohort.
Methods:
A total of 63 adults with ASD-ID, with a mean age of 42.9±15.1 years, were recruited from 2015 to 2017 from nine specialized institutions. They underwent detailed clinical examinations, including screening for comorbidities, ASD severity (CARS), adaptive functioning (VABS-II), autonomy (ADL), and drug use (polypharmacy and the Drug Burden Index (DBI)). The comorbidity burden was evaluated using the Cumulative Illness Rating Scale (CIRS-G) and its sub-scores (the severity index (CIRS-SI) and severe comorbidity (CIRS-SC)).
Results:
We found a large range of comorbidities, including gastro-intestinal disorders and mental and neurological diseases. Overall, 25% of our ASD-ID sample had chronic kidney disease with the associated increased cardiovascular risk factors. The comorbidity burden was high (mean CIRS-G total score of 10.6 ± 4.8), comparable to that observed among patients older than those in our population hospitalized in geriatrics departments. Furthermore, the comorbidity burden positively correlated with age, decreased autonomy, and polypharmacy.
Conclusion:
The severity of the comorbidity burden associated with premature ageing in adults with ASD and ID highlight their crucial need of personalized medical care.

Keywords: Autism Spectrum Disorder, Intellectual Disability, Ageing, comorbidity burden, CIRS

Received: 18 Dec 2018; Accepted: 01 Aug 2019.

Copyright: © 2019 Miot, AKBARALY, michelon, couderc, sophie, julie, marie-christine, éric, véronique, claude, Blain and amaria. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. stéphanie Miot, Centre de Ressources Autisme Languedoc-Roussillon, Montpellier, 34295, Languedoc-Roussillon, France, s-miot@chu-montpellier.fr