Characteristics of older adults with intellectual disabilities referred for crisis intervention.
Behavioral crises in adults with ID do not fade with age—check their medicines first.
01Research in Context
What this study did
The team looked back at 185 adults with intellectual disability who needed crisis help. All lived in the community and were 50 years or older.
They counted types of behavior problems and compared older versus younger adults in the same crisis service.
What they found
Aggression and non-compliance stayed just as common in the older group. Withdrawal, self-injury, and psychiatric signs actually dropped with age.
Bottom line: crisis behaviors do not simply fade as people with ID grow old.
How this fits with other research
O'Dwyer et al. (2018) later asked a national sample in Ireland and found the same thing—over half of older adults still showed problem behaviors.
Patton et al. (2020) and Agiovlasitis et al. (2025) add a twist: many adults in crisis take several psychotropic drugs, often off-label for behavior. Their data suggest medication side effects can keep crises going, not stop them.
So the 1999 picture of lasting aggression fits perfectly with newer work. The surprise is that heavy drug use, not age, may explain why behaviors stick around.
Why it matters
If you serve adults with ID, expect challenging behavior to stay on the caseload past age 50. Do not assume "older means calmer." Use Claire’s risk screen for psychotropic load, psychiatric diagnosis, and life events. Then team with medical staff to review medicines before you add more. Your behavior plan may work better after a med check.
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02At a glance
03Original abstract
The aim of the present study was to identify the age correlates of behavioural crises in adults with intellectual disability (ID) living in the community. The cohort consisted of 185 clients (IQ < 70), ranging in age from 20 to > 70 years, who were referred to a crisis intervention programme specializing in services to individuals with dual diagnosis over a 7-year period. A retrospective cross-sectional analysis of historical and contemporaneous variables was completed. Referrals for crisis intervention were not related to the age of the client Aggression and non-compliant behaviour occurred with similar frequency in all age groups. Other behaviours, including withdrawal, self-injury, stereotypy and symptoms of psychiatric disorders, occurred less often in older clients. Severity of ID affected the pattern of behavioural crises that resulted in referral. The results suggest that people with ID residing in community settings still experience behavioural crises as they grow older. Confirmation of the trends reported in the present study might signal a need for accelerating the development of comprehensive age-span community mental health and behavioural supports.
Journal of intellectual disability research : JIDR, 1999 · doi:10.1046/j.1365-2788.1999.43120173.x