Common conditions
Section: Common conditions | LD Toolkit template | RCGP Learning
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Common conditions
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People with a learning disability have on average 11 other health conditions. It is important for GPs to be aware of this and be able to manage the complexity that arises.
NHS Digital: health and care of people with learning disabilities
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There is evidence that people with a learning disability are at higher risk of being admitted to hospital. Many admissions can be prevented by interventions such as immunisations. Identifying an acutely unwell patient can be difficult; the RCP have produced guidance. The Health Services Safety Investigations Body have identified ways of improving care once someone is in hospital.
Royal College of Physicians: acute medical care for people with a learning disability
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Epilepsy is very common in people with a learning disability. About 1 in 5 people with mild to moderate learning disabilities have epilepsy compared with less than 1% of the general population. There is also evidence that individuals with a learning disability and epilepsy - particularly those with a moderate to profound learning disability - die at a significantly younger median age than those who died of other causes.
Epilepsy Society: learning disabilities
NICE guidance NG217: epilepsies in children, young people and adults
Sudep Action: SUDEP and seizure safety checklist
Sudep Action: the Clive Treacey safety checklist
NICE guidance NG217 summary: epilepsy and learning disabilities
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Respiratory problems are the commonest cause of avoidable death in people with a learning disability. 15% of all respiratory deaths in people with a learning disability were caused by aspiration pneumonia.
Bradford District Care NHS Foundation Trust: keeping my chest health
Asthma and Lung UK: how to use a pMDI inhaler
Bradford District Care NHS Foundation Trust 2022: vibrovest and nebuliser
Bradford District Care NHS Foundation Trust 2022: CPAP
Bradford District Care NHS Foundation Trust 2022: oxygen
NHS England: RightCare learning disability and aspiration pneumonia scenario
British Thoracic Society: diagnosis and management of aspiration pneumonia
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About 11% of people with a learning disability are recognised as experiencing dysphagia.
Easyhealth: swallowing problems
Bradford District Care NHS Foundation Trust: safe and enjoyable mealtimes
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Diseases of the heart and circulatory system are a common cause of death for people with a learning disability. The 2022 LeDeR report revealed that this was the commonest cause of death, accounting for 17% of all deaths. People with a learning disability have many other conditions that contribute to risk fo CV problems such as obesity, diabetes, inactivity and some chromosomal conditions like Down syndrome. Congenital heart disease is also much commoner in people with a learning disability, usually related to the syndrome causing the learning disability.
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About 50% of people reported to LeDeR were prescribed laxatives at the time of death. 50% were prescribed medication that could cause constipation.
NHS England: constipation resources for people with a learning disability
NHS South West: recognising the symptoms of constipation (Youtube Video)
NHS South West: treating constipation (Youtube Video)
BJGP: constipation in autistic people and people with a learning disability
King's College London: LeDeR 2021 constipation related deaths
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Both type 1 and type 2 diabetes are more common in people with a learning disability than in the general population. Type 2 diabetes arises at an age 10-15 years younger in people with a learning disability than in the general population.
Diabetes UK: what to do if you have type 2 diabetes
Diabetes UK: Improving care for people with diabetes and a learning disability
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Hypohyroidism is more common in people with a learning disability, particularly in those with Down Syndrome. Screening should be considered as part of the AHC.
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LeDeR found that 15% of adults with a learning disability died from cancer, making it the third most common cause of death in the LeDeR cohort. These patients presented at a later stage and died younger than the general population, over half within a year of presentation. Some of the most common cancers are bowel, oesophageal, lung and blood cancers.
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It may be difficult to recognise if someone with a learning disability is in pain. They may not have the words to describe how they are feeling: this is a particular problem for people with a learning disability who communicate without words. Pain may also present with 'challenging behaviour' such as unsual agression or agitation or head banging. Could a change in behaviour be an expression of pain? The Abbey Pain Scale can be used for people who are unable to say if they are in pain.
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