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Respiratory mortality in people with learning disabilities

Life Expectancy & Mortality | Last Updated: 16 Mar 26

Background

Respiratory disorders are a leading cause of death among people with learning/intellectual disabilities including preventable and treatable conditions such as pneumonia and aspiration. 

Higher rates of asthma, chronic obstructive pulmonary disease and upper respiratory tract infections have been reported for people with learning/intellectual disabilities.  People with profound and multiple learning/intellectual disabilities are particularly at risk of infections including pneumonia and gastro-oesophageal reflux disease.

Respiratory disease has been reported to be amongst the most common cause of death in children and young people with learning/intellectual disabilities, however the findings on respiratory-associated mortality are inconsistent.

What we did

We systematically reviewed all studies and analysed available data for deaths (n=1,844) from respiratory disorders in people with learning/intellectual disabilities from the last 35 years.

What we found

This study found that people with learning/intellectual disabilities are up to 11 times more likely to die from respiratory illness compared to the general population. In adults with learning/intellectual disabilities, this risk is 6 times higher compared to the general population.

We also found that the risk of death from pneumonia was 27 times higher for people with learning/intellectual disabilities compared to the general population, with influenza and injury from inhalation and aspiration events being common contributing factors

Many respiratory deaths among people with learning/intellectual disabilities are avoidable, with leading causes of death due to conditions that are treatable and amenable to good quality health and care.

What these findings mean

These findings demonstrate the need for further investigation of the risk factors associated with respiratory deaths in people with learning/intellectual disabilities and the need for improvements in primary prevention, such as training to increase awareness among carers and clinicians of the link between dysphagia and recurrent chest infections.

Further action to reduce community acquired pneumonia for people with learning/intellectual disabilities through targeted vaccination programmes is recommended in order to increase uptake.

Understanding the risk factors for respiratory associated deaths has important implications for disease management, the development of preventative strategies as well as for policy and practice to reduce premature deaths from respiratory-associated conditions. 

Related publications and outputs

Respiratory-associated deaths in people with intellectual disabilities: a systematic review and meta-analysis

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Presentation: Respiratory mortality in people with learning disabilities

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Easy read summary: respiratory mortality in people with learning disabilities

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Related research

Avoidable mortality in adults with learning disabilities
Life Expectancy & Mortality 10 February 2025

Team member(s) involved in this research

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Dr Maria Truesdale

Maria is a Senior Lecturer in Intellectual Disabilities at the University of Glasgow. Her goal is to improve the physical and mental health and wellbeing of people with intellectual disabilities and their carers through the evaluation, development and testing of complex interventions using gold standard methodology and inclusive research. Maria has conducted a number of trials using complex interventions in physical and mental health for people with intellectual disabilities and has played a central part in the development of a randomised control trial of the clinical and cost-effectiveness of the DESMOND-ID structured education programme for adults with intellectual disability and type 2 diabetes. This multi-site study is the largest funded trial internationally of a health behaviour intervention for people with an intellectual disability. Maria also supports the teaching and delivery of the Post Graduate Positive Behaviour Support programme and contributes to the supervision of University of Glasgow Postgraduate courses, namely MSc in Global Mental Health and MSc in Public Health. She is also the Mental Health and Wellbeing co-lead for Early Career Researchers. Recent and current projects have been funded by NIHR, ESRC (UK Research and Innovation), Baily Thomas Charitable Fund and The Burdett Trust for Nursing.

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Professor Craig Melville

Craig is a Professor of Neurodevelopmental Psychiatry in the School of Health and Wellbeing at the University of Glasgow. His work focuses on using evidence from research to inform the development of interventions and policy to improve the health of people with neurodevelopmental conditions. Craig has worked on clinical trials of complex interventions, such as psychological therapies, weight management and health checks in primary care. Evidence from epidemiological research has been central to the development of these clinical trials and his work with SLDO centres on how to use Scotland’s national datasets to understand and tackle the health inequalities experienced by people with neurodevelopmental conditions.

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Dr Kirsty Dunn

Kirsty is a Lecturer in Clinical Psychology at the University of Glasgow, and is an affiliate of the Scottish Learning Disabilities Observatory, having joined the team in 2015. She is interested in the health and wellbeing of individuals with learning disabilities and their families. Previously, Kirsty has worked on projects examining patterns of hospital admissions, prevalence of physical and mental health conditions, and the impact of caring for a son/daughter with learning disabilities on fathers. Her current research projects are exploring: The impact of bullying on young people's mental health Common mental health conditions experienced by children and young people Patterns of long-term health conditions and prescribing in adults

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Dr Laura Hughes

Laura is a Lecturer in Clinical Psychology at the University of Glasgow, and an affiliate of the Scottish Learning Disabilities Observatory, having joined the team in 2015. With the Observatory, Laura was involved in projects looking at the health of people with learning disabilities in a number of large data-sets, including primary health care records, Scotland's 2011 Census and health records of people born with Down Syndrome in Scotland over a 25 year period. Laura studied Psychology and has extensive experience of working with people with learning disabilities in her previous roles, for example, as a Befriender, a Learning Assistant and an Assistant Psychologist. Read more about Laura at the link below

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Dr Ewelina Rydzewska-Fazekas

Ewelina is an Affiliate Associate Researcher with the Scottish Learning Disabilities Observatory. Ewelina's work with the Observatory focused around health inequalities and the health needs of people with autism. She is now based at the University of Edinburgh School as a Lecturer in Health Futures at the Edinburgh Futures Institute and School of Health in Social Science.

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Dr Arlene McGarty

Arlene is a Research Fellow at the Scottish Learning Disabilities Observatory. Arlene is interested in lifestyle behaviours (for example, physical activity and sedentary behaviour) and how these impact the health of people with learning disabilities. She is also interested in finding ways to change these behaviours to help people with learning disabilities lead healthier and happier lives. Some of the projects that Arlene works on include: School-based “active play” for children with learning disabilities. Understanding walking opportunities in adults with learning disabilities. Increasing motor development skills in children with learning disabilities. Measuring energy expenditure in adults with learning disabilities.

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Professor Deborah Cairns

Deborah is the Director of the Scottish Learning Disabilities Observatory and Professor of Health and Neurodevelopmental Conditions, in the School of Health and Wellbeing, at the University of Glasgow. Deborah is passionate about her research which aims to improve the health of people with learning disabilities and their families. She has worked on many different projects about people with learning disabilities including: cancer incidence, cancer screening, multi-morbidity (having two or more health conditions), oral health and COVID-19, to name a few. She has also worked on projects about the physical and mental health of family members who support someone with a learning disability. Deborah is committed to conducting research that has impact and works closely with self-advocates with learning disabilities, family carers and third sector organisations who are pivotal in all of her work and who have a shared vision of ensuring the human rights of all people with learning disabilities are recognised, supported and upheld. Read more about Deborah here.