Stress and social isolation, and its relationship to cardiovascular risk in young adults with intellectual disability

Abstract

Purpose

Stress produces many physiological changes, some of which may contribute to the development of cardiovascular disease (CVD). Individuals with intellectual disability (ID) are exposed to multiple and stressful challenges everyday which may put them at increased cardiovascular risk. This current study aimed to establish whether adults with ID experience higher levels of subjective stress and encounter different stressors (including social isolation) than the general population, and whether there is a relationship between stress and cardiometabolic profile in this population.

Methods

Adults with ID (n = 35) aged 18–45 years completed the Subjective Stress Survey, and underwent a physiological assessment to measure blood pressure, metabolic profile and subclinical CVD risk factors, and were compared to a control group (n = 29). Multiple regression was used to investigate whether cardiometabolic parameters were predicative of SSS scores.

Results

Findings showed adults with ID have higher perceived stress levels (total score ID: 21.3 ± 11.4 vs control: 13.9 ± 9.0, p = 0.006), which is elicited by unique stressors, when compared to people without ID. Stress was strongly associated with increased social isolation (r = −0.38, p = 0.002) and with obesity in females with mild ID (r = 0.72). Regression showed that arterial stiffness was predictive of total SSS score (p = 0.038).

Conclusions

Adults with ID aged 18–45 years report higher levels of perceived stress when compared to people without ID.

Implications for Rehabilitation

• Reducing stress in this young population may prevent development of arterial stiffness, and consequently lower the risk of cardiometabolic morbidity and mortality.

• There are unique targets for stress management in young adults with intellectual disability, including supporting decision-making and improving self-efficacy.

• Improving community integration and reducing social isolation may decrease perceived stress in young adults with intellectual disability.

Keywords:

• Stress
• social isolation
• cardiovascular risk
• arterial stiffness

Acknowledgements

Yooralla community (Victoria) for facilitating the study, and their assistance in recruitment of participants. Goulburn Options community (Seymour, Victoria) for their assistance in recruitment of participants, and their hospitality in hosting the research team.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, CZ, upon reasonable request.

Notes

1 In 2021, the National Disability Insurance Scheme (NDIS) reported that 29% of people with ID (who were NDIS participants) were in paid employment 15.NDIS, Employment outcomes for NDIS participants 2021, National Disability Insurance Agency: NSW., hence, workplace stress is still an important consideration in this population.

2 All participants in the ID group were customers of Victorian disability service providers. Staff at these organisations provided evidence of ID diagnosis. Diagnosis was cross-checked with the individual participant and their proxy (if required).

Additional information

Funding

This study was supported by funds from the Iverson Health Innovation Research Institute, Swinburne University of Technology. Dr Clara Zwack is supported by a scholarship from Yooralla.