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Biomedical subjects

R K Eyman

Publications and source records attributed to R K Eyman.

At least 19 recordsLinked to original sources
PubMed1991

Life expectancy of persons with Down syndrome.

The longevity of people with Down syndrome being served by the California Department of Developmental Services was examined in terms of a number of variables known to be related to early mortality. The findings indicated that the predictors of survival for people with Down syndrome were not different from the variables related to mortality among people with mental retardation in general. A lack of mobility or feeding skills were better predictors of an early death than were medical problems associated with congenital heart disease. Life expectancy estimates of clients with Down syndrome who lacked mobility or eating skills were found to be poor as compared to individuals who had Down syndrome but did not have these problems regardless of the presence of heart disease.

Activities of Daily Living↗
PubMed1990

The life expectancy of profoundly handicapped people with mental retardation.

BACKGROUND: The life expectancy of people with mental retardation is shorter than that of the general population. Exact estimates of the length of survival for mentally retarded persons at especially high risk are not available, however. METHODS: We collected data on mortality and other factors for 99,543 persons with developmental disabilities, including mental retardation, who received services from the California Department of Developmental Services between March 1984 and October 1987. Three subgroups were selected on the basis of the four characteristics identified in previous studies as the best predictors of mortality among mentally retarded people (deficits in cognitive function, limitations on mobility, incontinence, and inability to eat without assistance). In all three subgroups, the subjects had severe deficits in cognitive function and were incontinent; the subjects in subgroup 1 (n = 1550) were immobile and required tube feeding; those in subgroup 2 (n = 4513) were immobile but could eat with assistance; those in subgroup 3 (n = 997) were mobile (but not ambulatory) and could eat with assistance. Life tables were generated for each of the three subgroups. RESULTS: Immobile subjects were found to have a much shorter life expectancy than those who could move about. Those who also required tube feeding (subgroup 1) had a very short life expectancy (i.e., four to five additional years). Those who could eat if fed by others (subgroup 2) had an average life expectancy of approximately eight additional years. In contrast, those who were mobile though not ambulatory (subgroup 3) had a life expectancy of about 23 additional years. CONCLUSIONS: Severe mental retardation is associated with a decrease in life expectancy, particularly for those who were immobile.

Activities of Daily Living↗
PubMed1990

Who are the dually diagnosed?

The evaluation of mental health problems among persons with mental retardation is complicated by difficulties in diagnosis as well as by system variables that may also determine who will be assigned a dual diagnosis. In this study a state data base of 78,603 individuals with mental retardation receiving state services was examined. The relations of observed behavior problems, other characteristics of the individual, and residential placement patterns to the likelihood of being given a dual diagnosis were examined. Extrapunitive maladaptive behaviors, cognitive abilities, and social skills were associated with diagnoses of mental health problems among persons with mental retardation. The different perspectives from which these results could be interpreted were discussed.

Adolescent↗
PubMed1988

Blood pressure at rest and during maximal dynamic and isometric exercise as predictors of systemic hypertension.

This study sought to verify evidence that transient high blood pressure (BP) at rest and during dynamic and isometric exercise is often predictive of later hypertension. In addition these 3 predictors were compared. One hundred office patients (all men) with BPs less than 140/90 mm Hg, ages 28 to 79 years, who had little or no heart disease and were not taking medication, had BPs taken at rest and during treadmill and handgrip dynamometer. Within 14 years, 16 subjects developed hypertension and 84 remained normotensive. Multivariate statistical comparisons for systolic and diastolic BPs and their interactions were used to discriminate between later hypertensive and normotensive subjects. The best single predictor was resting diastolic BP, classifying 88% of hypertensive and 69% of normotensive subjects correctly, followed closely by handgrip and treadmill diastolic BP and resting, treadmill and handgrip systolic BP. The best prediction was by the interaction between resting diastolic BP X handgrip diastolic BP; this classified 88% of hypertensive and 80% of normotensive subjects correctly. Of the few known precursors of hypertension, high BP at rest and during dynamic and isometric stress provides a means of alerting to careful follow-up and early treatment.

Adult↗
PubMed1988

Prediction of mortality in community and institutional settings.

This study attempted to re-evaluate predictors of mortality based on a large sample of mentally retarded individuals. Additionally, mortality rates were compared among several types of placements including institutions after controlling for the most salient predictors of death. The findings indicated that non-mobility and the need for medical support add to the risk of an early death for these children, and are significant indicators of mortality, regardless of level of retardation and placement.

Activities of Daily Living↗
PubMed1987

Life-span development of institutionalized and community-based mentally retarded persons, revisited.

Life-span development of adaptive behavior of 30,749 mentally retarded individuals residing in California and being served by the California Department of Developmental Services was studied. The estimated life-span trends differed somewhat from those reported in an earlier investigation (Eyman & Arndt, 1982.) We used a larger sample and a more appropriate model and found different growth curves in adaptive behavior over levels of retardation, contrary to the Eyman and Arndt findings. Moreover, when cross-sectional vs. semi-longitudinal growth curves were compared, the degree of similarity of the two types of curves was a function of level of retardation. Evidence on the need for large sample life-span studies based on at least 6 to 8 years follow-up was presented.

Activities of Daily Living↗
PubMed1987

Client characteristics and residential placement patterns.

Recent emphases on deinstitutionalization and community placement have been accompanied by the development of a range of residential placement alternatives and by shifts in the control of placement decisions. In this study we examined the patterns of placement into these alternatives for 66,367 clients receiving services for mentally retarded persons from the state of California and evaluated the ability of client characteristics to discriminate among clients in four residential placement types. Results of the discriminant analyses suggest that client characteristics, including maladaptive behavior, age, ethnicity, medical problems, ambulation, toileting, and speech, are important factors in the consideration of residential placement for mentally retarded people.

Activities of Daily Living↗
PubMed1986

Birth injury as the cause of mental retardation.

Mental retardation, on initial impression, may appear to be caused by the birth process, but may be disproved by later clinical or autopsy examination. However, information often is lacking as to the basic pathology that may have been responsible for attributing the cause of the mental retardation to traumatic birth. From a 39-year period (1944 to 1983) 1146 records were evaluated at a state hospital for mentally retarded persons to determine how the intake impression compared with the final clinical and autopsy diagnoses of perinatal damage. Clinical evaluations provided some corrections of the intake diagnoses; autopsies provided more, but a combination provided the most reliable final diagnoses. Of 258 patients diagnosed as birth injury on intake, only 49.2% were confirmed by the best clinical and/or autopsy diagnoses. Although the cause of mental retardation was not ascertainable by either clinical or autopsy studies in 14.8% of cases, 31.4% were corrected to prenatal influences, and 4.6% to postnatal brain damage. Patients with perinatal cause of mental retardation usually were institutionalized at a young age and died young. If they do not require institutionalization until they are older, their life expectancy is longer, although still much less than that of normal persons.

Adolescent↗
PubMed1985

Inability to cope with environmental stress: peptic ulcers in mentally retarded persons.

Mentally retarded persons in the protective environment of an institution developed more peptic ulcers than the general population. We sought to determine whether their physical and mental handicaps may have a relationship to this disease. Thirty seven mentally retarded institutionalized ulcer patients were compared to 37 non-ulcer controls matched for age and sex, who were also similar in IQ and mental retardation diagnoses. A stepwise discriminant analysis demonstrated that the ulcer group was more limited by chronic diseases and inability to ambulate. Also differentiating the groups were ulcer patients having more cerebral palsy, more visual deficit, and more limited motor and sphincter control than non-ulcer subjects. We conclude that helplessness in responding to environmental demands produces stress sufficient to induce peptic ulcers, even in severely mentally retarded persons.

Adolescent↗
PubMed1985

The relationship of congenital heart disease and respiratory infection mortality in patients with Down's syndrome.

Is respiratory infection mortality in Down's syndrome (DS) individuals due mainly to their congenital heart disease (CHD) or to other factors which subject most mentally retarded persons to risk? Detailed clinical and autopsy records of 137 institutionalized DS patients and 480 non-DS controls over 31 years yielded 42 DS subjects and 13 non-DS controls with congenital heart disease. These were compared to 20 DS patients and 20 controls without CHD. The DS and non-DS patients were matched for age, sex and IQ. DS patients had more CHD; controls had more pulmonary oedema. In neither group was there association between heart disease and death from respiratory infection. Nor did pulmonary oedema contribute importantly to such deaths. Such mortality, however, was associated with young age, short institutionalization and bedridden status. We conclude that respiratory infection death in DS individuals is due not primarily to heart disease but to factors which lead to mortality in the general population of retarded people.

Adolescent↗
PubMed1985

Place of residence by age, ethnicity, and level of retardation of the mentally retarded/developmentally disabled population of California.

California's data on their mentally retarded/developmentally disabled population, the largest set in the United States, were accessed to determine residency of clients by age, ethnicity, and level of retardation. Data on the desired variables were available for over 59,000 of the 64,000 clients in the records. Despite claims of excess institutional population and the availability of residential alternatives, 52.5% of all persons resided in their natural homes; small family care units held 14.2% of the population and institutions, 12.8%, these being the second and third among the eight types of residences identified by the state. The proportion of the population in the natural home decreased with age and level of retardation, dropping precipitously among profoundly and severely impaired persons. Anglo-white families kept fewer (44%) at home than did blacks, Latinos, and other ethnic groups combined.

Black or African American↗
PubMed1979

Comparison of respiratory mortality in the profoundly mentally retarded and in the less retarded.

Autopsy records of 600 profoundly retarded and 405 less retarded were examined for a thirty-one-year period at Pacific State Hospital. The profoundly retarded were found to have more respiratory infections at autopsy, and more deaths of such infections. Profound retardation was a particularly outstanding risk when in combination with epilepsy, inability to ambulate, and developmental cranial anomalies. Non-infectious respiratory morbidity and mortality are more common in the less retarded, apparently because of their living longer to develop these complications.

Adolescent↗
PubMed1979

Relationship between community environments and resident changes in adaptive behavior: a path model.

The relationship between environmental ratings of community homes using factor scores derived from Wolfensberger and Glenn's Program Analysis of Service System (PASS) and changes in adaptive behavior of residents living in those facilities was investigated. A path analysis was used to relate resident characteristics, e.g. age, IQ, and initial score on adaptive behavior, with six PASS environmental ratings and both of these sets of variables with average annual change in adaptive behavior over a 3-year period. The results showed that a number of PASS scores were significantly associated with positive change in adaptive behavior for specified types of residents. The most general finding was that older, less retarded residents improved in all aspects of adaptive behavior in conjunction with positive ratings on items dealing with comfort and deployment of staff, access to the home, local proximity of services, and blending with the neighborhood.

Adolescent↗