Anaemia
What is anaemia?
Anaemia means that the blood contains too few red blood cells, or that there is not enough haemoglobin (Hb) in these cells. As a result, less oxygen is transported in the blood. There are three main causes for this condition: the destruction of too many red blood cells, blood loss or the inadequate production of red blood cells by the bone marrow.
What are the complaints associated with anaemia?
Anaemia results in fatigue and a sensation of weakness, loss of appetite or energy, and a tight chest or shortness of breath with mild exertion. There may also be symptoms such as dizziness, feeling faint, palpitations, sweating, headache and ringing in the ears (tinnitus). People with anaemia may also look pale if there is a severe reduction in the haemoglobin level in the blood.
People with intellectual disabilities sometimes find it impossible to communicate their symptoms. The people around them may then notice only a change in behaviour.
How common is anaemia in the general population?
In the Netherlands, 12.5% of the population have anaemia; 24.8% of the global population have anaemia. The highest prevalences can be found in young preschool children, women and pregnant women in particular, schoolchildren and the elderly.
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The incidence rate for anaemia in general practice is 8.6 per 1000 annually. It can be attributed to iron deficiency in half of the patients and particularly in women between the ages of 15 and 50.
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How common is anaemia in people with intellectual disabilities?
In a Japanese study of 477 people in an intramural setting, 26% of the studied group had anaemia 81 . The condition was positively correlated with male gender and the use of anti-epileptic and antipsychotic medication. A high BMI and Down syndrome were correlated with a normal Hb.
In Taiwan, 11.6% of 973 schoolchildren with intellectual disabilities had anaemia
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. Predictive factors were younger age and female gender. There was a significant correlation with underweight and more severe intellectual disability.
In an American study of 1371 people with intellectual disabilities above the age of forty, more anaemia was found in people with cerebral palsy.
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The Dutch GOUD study found a prevalence of 16.8% for anaemia in older people (50+) with intellectual disabilities. There was a correlation with increased frailty in this group of older people.
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8Benoist de B, McLean E, Egli I, Cogswell M. Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. Geneva: World Health Organization 2008
Benoist de B, McLean E, Egli I, Cogswell M. Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. Geneva: World Health Organization 2008
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431NHG-werkgroep Anemie. NHG-Standaard Anemie. Huisarts Wet 2014;57(10):528-36
NHG-werkgroep Anemie. NHG-Standaard Anemie. Huisarts Wet 2014;57(10):528-36
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9Ohwada H, Nakayama T, Tomono Y, Yakanaka K. An eipemiological study on anemia among institutionalized people with intellectual and/or motor disability with special reference to its frequency, severety and predictors. MC Public Health. 2006 Apr 3;6:85
Ohwada H, Nakayama T, Tomono Y, Yakanaka K. An eipemiological study on anemia among institutionalized people with intellectual and/or motor disability with special reference to its frequency, severety and predictors. MC Public Health. 2006 Apr 3;6:85
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10Lin JD, Lin PY, Lin LP, Hsu SW, Loh CH, Yen CF, Fang WH, Chien WC, Tang CC, Wu CL. Prevalence and associated risk factors of anemia in children and adolescents with intellectual disabilities. Res Dev Disabil. 2010 Jan-Feb;31(1):25-32
Lin JD, Lin PY, Lin LP, Hsu SW, Loh CH, Yen CF, Fang WH, Chien WC, Tang CC, Wu CL. Prevalence and associated risk factors of anemia in children and adolescents with intellectual disabilities. Res Dev Disabil. 2010 Jan-Feb;31(1):25-32
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11Janicki MP, Davidson PW, Henderson CM, McCallion P, Taets JD, Force LT, Sulkes SB, Frangenberg E, Ladrigan PM. Health characteristics and health services utilization in older adults with intellectual disability living in community residences. J Intellect Disabil Res. 2002 May;46(Pt 4):287-98
Janicki MP, Davidson PW, Henderson CM, McCallion P, Taets JD, Force LT, Sulkes SB, Frangenberg E, Ladrigan PM. Health characteristics and health services utilization in older adults with intellectual disability living in community residences. J Intellect Disabil Res. 2002 May;46(Pt 4):287-98
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432Schoufour JD, Echteld MA, Boonstra A, Groothuismink ZM, Evenhuis HM. Biochemical measures and frailty in people with intellectual disabilities.Age Ageing. 2016 Jan;45(1):142-8
Schoufour JD, Echteld MA, Boonstra A, Groothuismink ZM, Evenhuis HM. Biochemical measures and frailty in people with intellectual disabilities.Age Ageing. 2016 Jan;45(1):142-8