Development of a frailty index for older people with intellectual disabilities: results from the HA-ID study.
A 51-item frailty index shows adults with ID age faster, and a later 17-item version still predicts decline.
01Research in Context
What this study did
The team built a 51-item frailty index for adults with intellectual disability. They pulled items from exams, blood tests, and caregiver reports.
All adults were 50 or older and lived in the Netherlands. No treatment was tested; the goal was a yardstick for future care.
What they found
Adults with ID aged 50-plus scored as frail as typical adults over 75. The index flagged vision loss, low grip strength, and many medications.
The tool was ready for clinics to spot early health decline.
How this fits with other research
Kremkow et al. (2022) later trimmed the list to 17 items. The short form still predicted death, so most teams now use the lighter version.
Berkovits et al. (2014) showed higher frailty scores forecast later problems with bathing, cooking, and walking. The index moved from description to early-warning system.
Spriggs et al. (2015) found the same scores predicted more medicines and new diseases three years later, but not falls or hospital stays. Frailty alerts you to chronic load, not acute injury risk.
Why it matters
If you serve adults with ID, add the 17-item short frailty index to annual assessments. A quick caregiver checklist spots who needs a doctor visit, fitness plan, or medication review before skills slip.
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02At a glance
03Original abstract
BACKGROUND: Although there is no strict definition of frailty, it is generally accepted as a state of high vulnerability for adverse health outcomes at older age. Associations between frailty and mortality, dependence, and hospitalization have been shown. We measured the frailty level of older people with intellectual disabilities (ID). Furthermore variation in gender, age, and level of ID were identified. Results were compared to a frailty study in the general European population. METHODS: This research elaborates on a large cross-sectional study: Healthy Ageing with Intellectual Disability (HA-ID). Nine hundred-eighty-two men and women (≥ 50 yr) with ID were included. Based on the collected data, we developed a frailty index with 51 health-related deficits, and calculated a frailty index score between 0 and 1 for each individual. Deficits included physical, social and psychological problems. RESULTS: The mean frailty index score was 0.27 (standard deviation .13). Frailty was positively correlated with age (r=0.297, p<.001). More severe ID was associated with higher frailty scores (β=0.440, p<001). The upper limit of the FI was 0.69, which was consistent for all age categories. CONCLUSION: As people with ID are getting older, the question whether additional years are spent in good health becomes salient. Here, people with ID over age 50 had frailty scores similar to most elderly people over 75 y. Future research is needed to confirm if frail elderly people with ID have an increased risk of adverse health outcomes.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.01.029