Heleen M Evenhuis's research while affiliated with Erasmus MC and other places

Publications (185)

Article
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Aim Visual functions of the dorsal stream are considered vulnerable in children with early brain damage. Considering the recognition of objects in suboptimal representations a dorsal stream dysfunction, we examined whether children with early brain damage and impaired object recognition had either general or selective dorsal stream dysfunctions. M...
Article
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Aim: In this study, we examined (1) the presence of abnormally low scores (below 10 th percentile) in various visual motion perception aspects in children with brain damage, while controlling for their cognitive developmental delay; (2) whether the risk is increased in comparison with the observation and expectation in a healthy control group and h...
Article
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Background: Low levels of physical fitness are associated with low physical and mental health. The aims of this study were to assess the health-related physical fitness of children with intellectual disability (ID), and study the association of physical activity and motor development with physical fitness. Methods: One hundred and twenty-eight chil...
Article
Background This study aimed to determine the relationship between motor abilities and quality of life in children with severe multiple disabilities. Methods In this cross‐sectional study, motor abilities of 29 children (mean age 9.8 years; 45% girls) with severe multiple disabilities [IQ < 25; Gross Motor Function Motor Classification System level...
Article
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Background Regular participation of children and adolescents with intellectual disabilites in physical activity is important to maintain good health and to acquire motor skills. The aim of this study was to investigate the habitual physical activity in these children. Methods Sixty‐eight children and adolescents (2–18 years) with a moderate‐to‐sev...
Article
We studied the association between multimorbidity, polypharmacy, and mortality in 1,050 older adults (50+) with intellectual disability (ID). Multimorbidity (presence of ≥ 4 chronic health conditions) and polypharmacy (presence ≥ 5 chronic medication prescriptions) were collected at baseline. Multimorbidity included a wide range of disorders, inclu...
Chapter
To facilitate the diagnosis of dementia in persons with intellectual disabilities (ID), based on observations of caregivers, since 1980 the Dementie Vragenlijst voor Zwakzinnigen (DVZ) has been developed by Heleen Evenhuis, ID physician, and Margeen Kengen and Harry Eurlings, behavioral therapists, all working in De Bruggen center for people with I...
Article
We aim to provide insight into the cause-specific mortality of older adults with intellectual disability (ID), with and without Down syndrome (DS), and compare this to the general population. Immediate and primary cause of death were collected through medical files of 1,050 older adults with ID, 5 years after the start of the Healthy Ageing and Int...
Article
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Physical fitness is an important marker for health. In this study we investigated the feasibility and reliability of health-related physical fitness tests in children with moderate to severe levels of intellectual disability. Thirty-nine children (2-18 yrs) performed tests for muscular strength and endurance, the modified 6-minute walk test (6mwt)...
Article
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In general, disabilities are considered a consequence of frailty rather than a cause of frailty, whereas in people with intellectual disabilities (ID), disabilities are often lifelong, which could have consequences for the feasibility and validity of frailty instruments. To better understand frailty in people with ID, we compared two broadly used c...
Article
Background: Bright light therapy (BLT) is effective in the treatment of depression in the general population. It may be a good treatment option for adults with intellectual disabilities (ID) too. However, its applicability and effectiveness are not studied in groups of adults with ID, yet. Our aim was to study the applicability of BLT in adults wi...
Article
Due to the limited cognitive and communicative abilities of adults with intellectual disabilities (ID), current treatment options for depression are often limited to lifestyle changes and pharmacological treatment. Bright light therapy (BLT) is an effective intervention for both seasonal and non-seasonal depression in the general population. BLT is...
Article
Background: Testing physical fitness in children and adolescents with intellectual disabilities (ID) can be challenging. This review provides an overview on psychometric properties of field-based physical fitness tests studied in children and adolescents with ID. Methods: A literature search was performed in March 2014. Studies were included if...
Article
Objective: The aim of the present study was to examine whether cognitive functioning (i.e., memory and executive functioning) is related to self-reported presence of pain (i.e., affirmative answer to the question whether the individual feels pain) and experience of pain (i.e., intensity and affect) in adults with Down syndrome (DS). Design, setti...
Article
Door hervormingen van het zorgstelsel is een deel van de mensen met een verstandelijke beperking (VB) nu aangewezen op de Wet Maatschappelijke Ondersteuning (de gemeente). Kennis over hun zelfredzaamheid, en de afname hiervan tijdens het ouder worden is belangrijk om de zorgverlening voor deze groep goed in te richten. Daarom richt deze studie zich...
Article
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Objective. The aim was to examine whether the presence of pain (based on physical conditions and participants’ report) and self-reported pain experience in adults with Down syndrome (DS) differ from general population controls. Design. Cross-sectional study of 224 adults with DS (mean age = 38.1 years, mild-severe intellectual disabilities) and 142...
Article
A Systematic Tool to Reduce Inappropriate Prescribing (STRIP), which includes the Screening Tool to Alert doctors to Right Treatment (START) and the Screening Tool of Older Peoples' Prescriptions (STOPP), has recently been developed in the Netherlands for older patients with polypharmacy in the general population. Active involvement of the patient...
Article
Background: With increasing longevity and a similar or increased prevalence of cardiovascular disease risk factors (as compared to the general population), people with intellectual disabilities (IDs) are at risk of developing cardiovascular disease. However, prospective studies on incidence and influencing factors of cardiovascular disease and mor...
Article
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Background Children with severe neurological impairment and intellectual disability are prone to low bone quality and fractures. Objective We studied the feasibility of automated radiogrammetry in assessing bone quality in this specific group of children. We measured outcome of bone quality and, because these children tend to have altered skeletal...
Article
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Background: The physical activity level of older adults with intellectual disabilities (ID) is extremely low, and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people. A physical activity programme, including an education programme, was developed for older adults with...
Article
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Objective. The presence of apolipoprotein E (ApoE) ɛ4 allele might be related to higher pain experience due to increased risk for potentially painful physical conditions and cognitive impairment (less efficient coping with pain). This hypothesis is clinically relevant to examine in adults with Down syndrome (DS) because they are at risk for painful...
Article
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Purpose: To determine whether the assessment of visual acuity ratios might improve the referral of children with (sub)normal visual acuity but at risk of cerebral visual impairment. Methods: In an exploratory study, we assessed visual acuity, crowding ratio and the ratios between grating acuity (Teller Acuity Cards-II) and optotype acuity (Cambr...
Article
Based on a systematic review, psychometric characteristics of currently available instruments on motor abilities of children with disabilities were evaluated, with the aim to identify candidates for use in children with severe multiple (intellectual and motor) disabilities. In addition, motor abilities are essential for independent functioning, but...
Article
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Aim: Evaluation of motor abilities of children with severe multiple disabilities is often based on subjective assessment or on instruments validated for other target populations. A practical instrument for the evaluation of change in motor abilities is needed. In this study such an instrument is constructed and its content validity and applicabilit...
Article
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Aim: ‘MOtor eVAluation of KIds with multiple and Complex disabilities’ (Movakic) is a newly developed Dutch instrument for evaluating motor abilities in children with severe multiple disabilities. We have previously shown that its feasibility and content validity are satisfactory. The aim of this study is to investigate test-retest and inter-rater...
Article
Introduction: People with intellectual disabilities (ID) are earlier frail than people in the general population. Although this may be explained by lifelong unfavourable social, psychological and clinical causes, underlying physiological pathways might be considered too. Biological measures can help identify pathophysiological pathways. Therefore,...
Article
The use of the Self-reporting Tool On Pain in people with Intellectual Disabilities (STOP-ID!), an online application developed by the authors to aid in the self-reporting of pain, was evaluated in 40 adults with Down syndrome. Comprehension of the use of the tool (the ability to recognize representations for vocabulary and pain, and to navigate th...
Article
The spinothalamic pathway mediates sensations of temperature, pain, and touch. These functions seem impaired in children with Down syndrome (DS), but have not been extensively examined in adults. The objective of the present study was to compare the spinothalamic-mediated sensory functions between adults with DS and adults from the general populati...
Article
A frailty index is a quantitative measure of frailty, based on the nonspecific accumulation of deficits. In the general population the frailty index strongly predicts death and deterioration of independence and health. Few studies focus on frailty in people with intellectual disabilities (ID). However, because of the increasing longevity of people...
Article
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Background Adults with Down syndrome (DS) are at risk for age-related painful physical conditions, but also for under-reporting pain. Pictograms may facilitate self-report of pain, because they seem suitable for the global visual processing in DS and for iconic representation of abstract concepts.Method Participants (N = 39, M age = 41.2) assigned...
Article
The ability to perform instrumental activities of daily living (IADL) is important for one's level of independence. A high incidence of limitations in IADL is seen in older adults with intellectual disabilities (ID), which is an important determinant for the amount of support one needs. The aim of this study was to assess the predictive value of ph...
Article
Although the population with intellectual disabilities (ID) is increasingly growing older, there seems to be an early onset of functional decline in this group, which could be explained by frailty. We used data from the Healthy Aging and Intellectual Disability study (HA-ID) to measure frailty in people with ID. Frailty was measured with an adapted...
Article
Background Polypharmacy, a risk factor for inappropriate prescribing, is common in adults with intellectual disability (ID). For older patients with polypharmacy in the general population a Systematic Tool to Reduce Inappropriate Prescribing (STRIP)* has been developed recently. This patient review requires the active involvement of the patient, wh...
Article
To analyze the relationship between frailty and survival in older people with intellectual disabilities (IDs). Population-based longitudinal observational study. Three Dutch care provider services. Individuals with borderline to profound ID aged 50 and older (N = 982). A frailty index (FI) including 51 health-related deficits was used to measure fr...
Article
Frailty in older people can be seen as the increased likelihood of future negative health outcomes. Lifelong disabilities in people with intellectual disabilities (ID) may not only influence their frailty status but also the consequences. Here, we report the relation between frailty and adverse health outcomes in older people with ID (50 years and...
Article
Frailty appears to develop earlier and is more severe in people with intellectual disabilities compared to the general population. The high prevalence of frailty may lead to an increase in care intensity and associated health care costs. Therefore a longitudinal observational study was conducted to determine the effect of frailty on care intensity....
Article
Objective: To investigate how doctors can improve the advice and education about sexuality and contraception given to young people with mild intellectual disability (IQ :50-70). Design: Semi-structured interviews. Method: Young people attending special needs secondary schools (IQ: 50-70) were interviewed. Pupils with a known history of sexual...
Conference Paper
Background: Frailty is a state of increased vulnerability to adverse health outcomes compared to others of the same age. Frailty challenges much of health care, which will likely further increase due to the aging of the population. People with intellectual disabilities (ID) are more frequently and earlier frail compared to the general population. B...
Article
A high incidence of limitations in daily functioning is seen in older adults with intellectual disabilities (ID), along with poor physical fitness levels. The aim of this study was to assess the predictive value of physical fitness for daily functioning after 3 years, in 602 older adults with borderline to profound ID (≥50 years). At baseline, phys...
Article
Frailty is a state of increased vulnerability to adverse health outcomes compared to others of the same age. People with intellectual disabilities (ID) are more frequently and earlier frail compared to the general population. Frailty challenges much of health care, which will likely further increase due to the aging of the population. Before effect...
Article
Full-text available
Abstract Older people with intellectual disability (ID) are characterized by low physical activity (PA) levels. PA is important for reducing health risks and maintaining adequate fitness levels for performing activities of daily living. The aim of this study was to explore preferences of older adults with ID for specific physical activities, and to...
Article
A high incidence of falls is seen in people with intellectual disabilities (ID), along with poor balance, strength, muscular endurance, and slow gait speed, which are well-established risk factors for falls in the general population. The aim of this study was to assess the predictive value of these physical fitness components for falls in 724 older...
Article
Although osteoporosis is a progressive bone disease leading to increased risk of fracture, it has rarely been investigated on a large scale in older people with intellectual disabilities (ID). In this study, 768 persons with ID (aged≥50 years) were measured with quantitative ultrasound to determine the prevalence of low bone quality. The associatio...
Article
This paper describes the results of the process evaluation of a physical activity programme for people with intellectual disabilities (ID), including information about the concepts 'fidelity', 'dose delivered', 'satisfaction' and 'context'. Qualitative and quantitative methods among participants and programme leaders were used. The programme was we...
Article
Multimorbidity may be related to the supposed early aging of people with intellectual disabilities (ID). This group may suffer more often from multimorbidity, because of ID-related physical health conditions, unhealthy lifestyle and metabolic effects of antipsychotic drug use. Multimorbidity has been defined as two or more chronic conditions. Data...
Article
Heart rate recovery (HRR) after exercise is an independent predictor for cardiovascular and all-cause mortality. To investigate the usefulness of HRR in cardiorespiratory exercise testing in older adults with intellectual disabilities (ID), the aims of this study were (a) to assess HRR in older adults with ID after the 10-m incremental shuttle walk...
Article
Cardiovascular disease occurs as frequently in older people with intellectual disabilities as in the same aged general population. However, there are indications for underdiagnosis of myocardial infarction due to atypical or absent complaints. Obesity, diabetes and peripheral arterial disease are more common in this group than in the general popula...
Article
With increasing longevity and cardiovascular events, chronic kidney disease may also become a significant problem in older people with intellectual disability (ID). We studied prevalence and associations of chronic kidney disease as part of the Healthy Ageing and Intellectual Disability (HA-ID) study, a large Dutch cross-sectional study among peopl...
Article
Older people with intellectual disabilities (ID) may experience more and different symptoms of anxiety than older people with normal intelligence. Study questions: (1) Is the reported severity of anxiety in this group similar to that in the general older population; (2) Are specific anxiety symptoms reported as frequently by both groups? Cross-sect...
Article
Background: The Actiwatch is increasingly being used to investigate sleep. The aim of this study was to investigate which sensitivity setting of the Actiwatch is most suitable to detect sleep disturbance in older adults with intellectual disability (ID). Method: Two Actiwatch types were compared to polysomnography (PSG) in 10 older adults with m...
Article
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Older people with intellectual disabilities have very low physical activity levels. Well designed, theory-driven and evidence-based health promotion programmes for the target population are lacking. This paper describes the design of a cluster-randomised trial for a systematically developed health promotion programme aimed at improving physical act...
Article
People with intellectual disabilities are at high risk for pain and have communication difficulties. Facial and numeric scales for self-report may aid pain identification. It was examined whether the comprehension of a facial affective scale and a numeric scale for pain in adults with Down syndrome (DS) varies with presentation format. Adults with...
Article
Frailty is increasingly being recognized as a relevant health measure in older populations, associated with an increased risk of adverse health outcomes and care dependency. Because it is generally perceived that people with intellectual disabilities are "old" from age 50 onwards, frailty research in this group might lead to an understanding of fac...
Article
Cardiorespiratory fitness is the ability of the circulatory, respiratory and muscular systems to supply oxygen during sustained physical activity. Low cardiorespiratory fitness levels have been found in individuals with intellectual disabilities (ID), which puts them at higher risk for cardiovascular diseases and all-cause mortality. The aims of th...
Article
Full-text available
People with intellectual disabilities (IDs) have a higher risk of painful medical conditions. Partly because of the impaired ability to communicate about it, pain is often undertreated. To strengthen pain assessment in this population, we conducted a systematic review to identify behavioral pain indicators in people with IDs by using Embase, PubMed...
Article
The objective of this article is to study which factors are associated with depression and anxiety in older adults with intellectual disabilities (ID). Depressive and anxiety symptoms were studied in 990 participants with borderline to profound ID, aged ≥ 50 years, using self-report and informant-report screening questionnaires. In 290 participants...
Article
Individuals with intellectual disability frequently use antipsychotics for many years. This may have detrimental health effects, including neurological symptoms and metabolic and hormonal dysregulation, the latter possibly affecting bone metabolism. There is large variability in the degree in which antipsychotic agents lead to these health problems...
Article
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Antipsychotics are frequently prescribed agents in individuals with intellectual disability, often for behavioral symptoms. Efficacy of antipsychotics for this is ambiguous, so discontinuation should be considered. Weight gain and metabolic dysregulation are well-known adverse effects of antipsychotics which increase the risk of the metabolic syndr...
Article
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Excessive prescribing of antibiotics in patients with lower respiratory tract infections (LRTIs) is common in the general population. Due to communication difficulties, it is hypothesised that prescriptions are even more commonplace in the primary care of individuals with intellectual disabilities. Point-of-care C-reactive protein (POC-CRP) testing...
Article
Background: Depression, anxiety, diabetes and cardiovascular risk factors are frequent health problems among older people with intellectual disability (ID). These conditions may be bidirectionally related. Depression and anxiety may have biological effects causing glucose intolerance, fat accumulation and also lifestyle changes causing metabolic s...
Article
Prescribing pharmacotherapy for older individuals with an intellectual disability (ID) is a complex process, possibly leading to an increased risk of prescription errors. The objectives of this study were (1) to determine the prevalence of older individuals with an intellectual disability with at least one prescription error and (2) to identify pot...
Article
Older people with an intellectual disability (ID) have been shown to have similar to increased cardiovascular risks as compared to the general population. Peripheral arterial disease (PAD), atherosclerosis distal from the aortic bifurcation, is associated with increased cardiovascular morbidity and mortality. The prevalence of PAD has not been inve...