Associations between physical fitness and cardiovascular disease in older adults with intellectual disabilities: Results of the Healthy Ageing and Intellectual Disability study.
Among older adults with ID, heart disease shows up first as slower walking, not weaker grip.
01Research in Context
What this study did
The team checked fitness levels in older Dutch adults with intellectual disability. They compared people who already had heart disease with people who did not.
They measured how far people could walk in six minutes, how fast they walked, and how hard they could squeeze with each hand.
What they found
Adults with heart disease walked shorter distances and moved slower. Their grip strength looked the same as everyone else.
The link stayed strong even after the researchers counted age, sex, and other health problems.
How this fits with other research
Rose et al. (2000) warned that adults with ID in UK homes sit too much and eat poorly. The new data show that when heart trouble starts, walking ability drops first.
Oppewal et al. (2013) showed grip strength varies a lot in this group. The current study agrees: grip did not flag heart disease, so walking tests matter more.
Garwood et al. (2021) found heart disease is still the top killer of US adults with ID. Linking low walking scores to existing heart trouble gives us an early warning tool.
Why it matters
You can spot heart-related decline without fancy gear. Time a six-minute walk or count steps across the day. If speed drops, refer to the nurse or physician early. Add short hallway walks or outdoor loops to the behavior plan. Better endurance may slow further heart damage and keep clients active longer.
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02At a glance
03Original abstract
BACKGROUND: Reduced physical fitness is a cardiovascular disease (CVD) risk factor in the general population. However, generalising these results to older adults with intellectual disabilities (ID) may be inappropriate given their pre-existing low physical fitness levels and high prevalence of co-morbidities. Therefore, the aim of this study is to investigate the difference in physical fitness between older adults with ID with and without CVD. METHOD: Baseline data of a cohort of older adults with borderline to profound ID (HA-ID study) were used (n = 684; 61.6 ± 8.2 years; 51.3% male). CVD status (coronary artery disease, heart failure, stroke) was obtained from medical files. Cardiorespiratory fitness (10-m incremental shuttle walking test), comfortable and fast gait speed (over 5 m distance) and grip strength (hand dynamometer) were measured. Multivariable linear regression models were used to investigate the association between these physical fitness components and the presence of CVD, adjusted for participant characteristics. RESULTS: Of the 684 participants 78 (11.4%) had CVD. Participants with CVD scored lower on cardiorespiratory fitness (-81.4 m, P = 0.002), comfortable gait speed (-0.3 km/h, P = 0.04) and fast gait speed (-1.1 km/h, P = 0.04). No significant differences were found for grip strength (-0.2 kg, P = 0.89). CONCLUSIONS: Older adults with CVD had significantly lower physical fitness levels than those without CVD, except for grip strength. Longitudinal research is needed to investigate causality.
Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13027