Mental health of older people with mild and moderate intellectual disability in Australia.
One-third of Australians with ID over 60 live with mental health disorders, and bad life events plus physical illness—not age or sex—are the culprits.
01Research in Context
What this study did
Researchers asked older Australians with mild or moderate intellectual disability about their mental health. They looked at people over 60 who live in the community, not in large institutions.
The team wanted to know how many had mental health disorders and what factors went with them. They checked life events, physical illnesses, age, sex, and where people lived.
What they found
About one in three adults reported a current mental health disorder. Bad life events and several physical illnesses stood out as the main links.
Age, sex, and city versus country made no difference. The problems came from what happened to them, not who they were or where they lived.
How this fits with other research
Titlestad et al. (2019) asked the same questions in Ireland and got the same answer: life events drive mental ill-health in older adults with ID. The match across two countries makes the link stronger.
Hastings et al. (2002) and Meyer (1999) showed that physical illnesses pile up as people with ID age. The new study adds that those illnesses travel hand-in-hand with mental disorders, updating the picture.
Haider et al. (2013) found worse health across all Victorian adults with ID. The 2021 survey zooms in on the 60-plus group and spells out the mental-health part of that burden.
Why it matters
When you assess an older client with ID, ask about recent losses, moves, or bereavements right after you check vital signs. Use that list to flag who needs a mental health referral and who needs physical problems treated first. A quick life-events screen at intake can guide your whole care plan.
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02At a glance
03Original abstract
BACKGROUND: The progressive increase in life expectancy of people with intellectual disability (ID) has resulted in enhanced survival into old age and has also seen a growth in research on both lifelong and emerging ageing-related health issues. Health issues amongst provider-supported adults have been previously studied, but these studies have not always included older community-dwelling adults with ID. METHODS: A study examining the extent of mental health of 391 community-dwelling adults with ID age 60 and older in both metropolitan and rural areas of two East Coast Australian states was undertaken using a cross-sectional survey. Examined were a range of demographic (age, sex, living arrangements, employment and socio-economic status) and life (co-morbidities, adverse life events and social support) factors. Data were parsed by two age groupings (60-65: n = 234 and >65: n = 157). RESULTS: Findings revealed that older community-dwelling adults with ID have many of the same mental health disorders as do other ageing people, with the exception of significant psychiatric disorders often associated with older age. Over a third (35%: n = 137) reported some one or more mental health disorders. Age, sex, location (rural or urban), financial hardship, social support or type of living arrangement were not statistically significant as risk factors for poor mental health. However, employment status was a clear predictor. Stepwise regression models showed a strong association between mental ill-health and adverse life events and between mental ill-health and multiple physical co-morbidities. CONCLUSIONS: The cross-sectional nature of the study limits causal inference. The cumulative effect of chronic health conditions and adverse life events cannot be prevented retrospectively. However, greater awareness amongst both health professionals and care staff that older adults with ID have a high likelihood of significant and/or repeated traumas and need better health care to limit physical co-morbidity may assist in providing support that is better tailored to individual needs in older age to reduce the burden of mental ill-health.
Journal of intellectual disability research : JIDR, 2021 · doi:10.1111/jir.12825