Identifying and understanding the co-occurrence of multiple long-term conditions (MLTC) in individuals with intellectual disabilities (ID) is vital for effective healthcare management. These individuals often face earlier onset and higher prevalence of MLTCs, yet specific co-occurrence patterns remain unexplored. This study applies an unsupervised approach to characterise MLTC clusters based on shared disease trajectories using electronic health records (EHRs) from 13069 individuals with ID in Wales (2000-2021). Disease associations and temporal directionality were assessed, followed by spectral clustering to group shared trajectories. The population consisted of 52.3% males and 47.7% females, with an average of 4.5 conditions per patient. Males under 45 formed a single cluster dominated by neurological conditions (32.4%), while males above 45 had three clusters, the largest characterised circulatory (51.8%). Females under 45 formed one cluster with digestive conditions (24.6%) as most prevalent, while those aged 45 and older showed two clusters: one dominated by circulatory (34.1%), and the other by digestive (25.9%) and musculoskeletal (21.9%) system conditions. Mental illness, epilepsy, and reflux were common across groups. These clusters offer insights into disease progression in individuals with ID, informing targeted interventions and personalised healthcare strategies.

翻译：识别和理解智力障碍患者中多重长期共病的共现模式对于有效的医疗管理至关重要。这类人群通常面临更早发病和更高的多重长期共病患病率，但具体的共现模式尚未得到充分探索。本研究采用无监督方法，基于威尔士13069名智力障碍患者的电子健康记录（2000-2021年），通过共享疾病轨迹对多重长期共病聚类进行特征刻画。研究评估了疾病关联性与时间方向性，并采用谱聚类方法对共享轨迹进行分组。研究人群包含52.3%男性和47.7%女性，平均每位患者患有4.5种疾病。45岁以下男性形成以神经系统疾病为主（32.4%）的单一聚类；45岁以上男性形成三个聚类，其中最大规模聚类以循环系统疾病为特征（51.8%）。45岁以下女性形成以消化系统疾病为主（24.6%）的单一聚类；45岁及以上女性呈现两个聚类：一个以循环系统疾病为主导（34.1%），另一个以消化系统（25.9%）和肌肉骨骼系统疾病（21.9%）为特征。精神疾病、癫痫和反流性疾病在各组中普遍存在。这些聚类结果为理解智力障碍患者的疾病进展提供了新视角，可为针对性干预和个性化医疗策略的制定提供依据。