Asthma/COPD

What are asthma and COPD?

Asthma is a chronic inflammation of the respiratory tract that is associated with a narrowing of the airways and increased airway irritability. Chronic Obstructive Pulmonary Disease (COPD) is a chronic narrowing of the airways that interferes with breathing. COPD includes chronic bronchitis and emphysema. Chronic bronchitis is a chronic inflammation of the mucosa due to prolonged exposure to certain irritants. Emphysema results in a loss of elasticity in the lungs and the loss of lung tissue. COPD and asthma are obstructive lung diseases.

What are the complaints associated with asthma and COPD?

The symptoms of asthma are shortness of breath, tightness of the chest, wheezing and coughing (especially at night and in the morning). In children, the main symptoms are wheezing and coughing, and fullness and wheezing in children under the age of one year. The symptoms are seen in episodes that can last for longer or shorter periods of time. Episodes and periods with symptoms alternate with symptom-free periods. COPD manifests itself as shortness of breath, coughing and/or coughing up mucus. ⁵³⁸

How common are asthma and COPD in the general population?

The one-year prevalence in the general population is 3.2% for asthma and 2.0% for COPD.
Asthma usually begins in early childhood, but it can also begin after the age of 50. The incidence of asthma in general practice is approximately 6 per 1000 adults per year and it declines with age. The prevalence rate in general practice is 35 per 1000, declining from between 35 and 40 per 1000 in adolescents to 26 per 1000 in people aged over seventy-five. In general practice, asthma is 1.5 times more common in adult women than in men. ²⁵⁸

How common are asthma and COPD in people with intellectual disabilities?

A Dutch questionnaire study answered by the parents of all 2271 adolescents with intellectual disabilities in the provinces of Groningen and Drenthe found that the one-year prevalence for asthma was 9.9%. ²⁵⁹
The European POMONA questionnaire survey looked at a random sample of 1269 adults with intellectual disabilities and found that 6.3% had asthma. ²⁶⁰

The Dutch GOUD study of 1050 people aged over 50 with intellectual disabilities found that 13.6% had asthma/COPD.  ⁵³⁹

An English study of 1097 people with intellectual disabilities found that 12% had asthma, twice as many as in the general population ²⁶¹ . This study showed that people with asthma smoked more often or were more often overweight than people without asthma; smoking and/or obesity are associated with an increased risk of a worse course of the disease.

Other studies show that asthma in children ²⁶²  and adults ²⁶³  with intellectual disabilities is more often a cause of death than in people without intellectual disabilities.

Asthma is more common in children with Down syndrome than in children with intellectual disabilities but no Down syndrome. ²⁶⁴

Furthermore, it is important to provide people with intellectual disabilities with proper instructions, to practice and to check whether inhalation medication is being used properly. ^{540   541}