[The relationship between the gross motor function and the causes of death in persons with severe motor and intellectual disabilities].

Objective: We investigated the relationship between the gross motor function and the causes of death and complications in persons with severe motor and intellectual disabilities (SMID).

Methods: The causes of death, complications and ages of the 777 patients who had been admitted to the wards for persons with SMID in institutions involved in the national hospital organization and died from 1999 to 2008, were reported. Of these patients, 679 patients had data available. The patients were divided into 4 groups; group A (479 cases who could not roll over), group B (31 cases who could roll over but could not sit up), group C (53 cases who could sit up but could not stand up), and group D (22 cases who could stand up but could not walk without support).

Results: The frequency of swallowing disturbance in group A was significantly higher than that in the other groups, while the frequency of gastroesophageal reflux was significantly lower in group C than in groups A and B. The percentage of tube feeding in group A was higher than that in the other groups. The differenc between groups A and C was statistically significant. The frequency of tracheotomy in group B was significantly lower than in group A and there were no cases of tracheotomy in groups C and D. Concerning the causes of death, the percentages of respiratory disorders in groups A, B, C, D were 52.4, 32.3, 35.8, 31.8, respectively. The mean age of death in group A was about 10 years younger than in the other groups.

Conclusions: The gross motor function predicted the likelihood of respiratory and digestive systems complications and was related to life expectancy.