Comorbidities and Secondary Conditions

By Waldman, H. Barry; Rader, Rick et al. | The Exceptional Parent, December 2009 | Go to article overview

Comorbidities and Secondary Conditions


Waldman, H. Barry, Rader, Rick, Wong, Allen, Perlman, Steven P., Chaudhry, Ramiz A., The Exceptional Parent


Comorbidity and secondary conditions in adults with intellectual and other disabilities can affect significantly the health provider's decisions for clinical management of a patient. While comorbidity conditions may frequently be considered by practitioners and family members, secondary conditions (e.g. social, emotional, family, and community factors) require additional consideration. Government reports are used to describe the wide variations in the prevalence rates of some of these conditions at the state level in an effort to promote health provider attention to this relevant information.

The evidence of comorbidity; i.e. establishing the relationships between the various conditions in one person and understanding the implications for total health services, can affect significantly the clinical management and referrals for individuals with disabilities. (1) But so too can secondary conditions. A secondary condition is "any condition to which a person is more susceptible by virtue of having a primary disabling condition." (2) Comorbidity refers to the existence of additional diseases after diagnosis of the primary disabling condition. Secondary conditions add three dimensions not fully captured by the term comorbidity. They include: 1) non-medical events, e.g. isolation; 2) conditions that affect the general population, but to a greater extent affect people with a disabling condition; e.g. obesity; and 3) problems that arise any time during the lifespan, e.g. inaccessibly to medical facilities. (3) Comorbidities and secondary conditions may best be visualized using Venn diagrams (i.e. the use of overlapping circles to show relationships between varying factors).

An understanding by family members, daily care providers, and supervising health practitioners of the consequences of concurrent conditions can enhance early recognition of systemic developments and the potential consequences of comorbidities and secondary conditions. For example, the Charlson comorbidity index is used to predict the one-year mortality of patients who may have a range of comorbid conditions such as heart disease, AIDS or cancer (a total of 22 conditions). Each condition is assigned with a scored of 1,2,3 or 6 depending on the risk of dying associated with the condition. The scores are summed up and given a total score which predicts mortality. Decisions based on severity vs. costs, risks of treatment and short-term benefits can be determined. (4)

SPECIFICALLY, INTELLECTUAL DISABILITIES

A growing awareness of comorbidity and secondary factors affecting individuals with intellectual disabilities (ID) is emphasized in an extensive literature which focuses on 1) the increased life expectancy of individuals with ID and integration in their communities with resultant needed services from local practitioners, 2) emphasis on often overlooked health concerns (e.g. sexually transmitted diseases and end of life decisions), 3) frequent reports of associated psychiatric syndromes, and 4) the need to establish comprehensive treatment protocols (including routine periodic health screenings to review medical and behavior disorders) common to the population of individuals with ID. (5-16)

The recognition of comorbidities and secondary conditions is not limited to individuals with ID. It extends into all aspects of care for individuals with a wide array of disabilities and the general population. For example, epilepsy is prevalent among those with other disabilities, including autism (25.5%), cerebral palsy (13%), Down syndrome (13.6%), and intellectual disabilities (25.5%). Forty percent of people who have both cerebral palsy and intellectual disabilities also have epilepsy. (17)

There are increasing reports of comorbidities and secondary conditions among individuals with various psychological diagnoses and involving the growing geriatric population. (18-20) Adults with ID "... have more medical problems than do age-matched persons (in the general population), approximately five medical conditions per person. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • A full archive of books and articles related to this one
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Comorbidities and Secondary Conditions
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.