Characteristics of the least frail adults with intellectual disabilities: a positive biology perspective.
Fewer than 7% of adults 50+ with ID are “least frail,” but fitness and health-focused goals can move more clients into that group.
01Research in Context
What this study did
The team looked at 1,050 Dutch adults with intellectual disability who were 50 or older. They used a 51-item frailty index to sort people into groups. Then they described the smallest group: the 6.6% who scored as “least frail.”
They checked age, level of ID, health problems, and Down-syndrome status. The goal was to see what the healthiest older adults with ID look like.
What they found
Only about 1 in 15 adults met the “least frail” cut-off. These people were younger, had milder ID, almost no Down syndrome, and fewer long-term health issues.
In plain words, the bar for “healthy ageing” is very low in this population. Most clients already carry several health deficits before they turn 60.
How this fits with other research
Prigge et al. (2013) built the 51-item index first. The 2014 paper simply used that tool to paint a picture of the best-scoring clients.
Kremkow et al. (2022) later trimmed the list to 17 items. The short form works just as well, so you can now screen frailty faster in day-to-day practice.
Two follow-up studies tracked the same cohort for three years. D et al. (2014-follow-up) and Oppewal et al. (2015) showed higher baseline frailty predicts later trouble with daily skills, more medicines, and more illnesses. The cross-sectional “least frail” snapshot therefore doubles as an early-warning radar: clients who already look like the healthy group are the ones most likely to stay independent.
Oppewal et al. (2014) and Oppewal et al. (2015) also found that poor fitness—not just frailty—forecasts decline. Together these papers point to the same action plan: keep clients moving, keep weight down, and watch mood.
Why it matters
If you support adults with ID, assume most are on the path to frailty well before 60. Use the 17-item short index to flag risk, then write goals for mobility, fitness, and mental health. Even small gains in gait speed or balance can push a client toward that rare “least frail” zone and buy years of independence.
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02At a glance
03Original abstract
The current study focuses on the characteristics of older people with intellectual disabilities with the lowest frailty levels. Frailty is an increased risk of adverse health outcomes and dependency. Older adults with intellectual disabilities (ID) show more signs of early frailty than the general population. Knowledge of the least frail group characteristics may provide insight into possibilities to prevent early frailty in older people with intellectual disabilities. This study was part of the Healthy Aging and Intellectual Disability study (HA-ID) which incorporated 1050 adults aged 50 years and over with all levels of ID. Frailty was measured with a frailty index. The least frail group was selected based on a frailty index score ≤ 0.10. Odds ratios were used to compare the occurrence of health deficits in the least frail group to the remaining group. The least frail group consisted of 65 participants, corresponding with 6.6% of the study population. The least frail group was significantly younger, had less severe levels of ID, and less often Down syndrome than the remaining group. The lack of mobility and physical fitness limitations, dependence, no signs of depression/dementia, and little medical problems characterized the least frail group. The percentage of 50+ adults with intellectual disabilities within the least frail group is very low compared to that in the general aging population (>43%). Interventions to prevent or delay frailty in this population are highly recommended and can focus on health characteristics of the least frail group.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.10.016