Physical fitness is predictive for a decline in the ability to perform instrumental activities of daily living in older adults with intellectual disabilities: Results of the HA-ID study.
Poor fitness now means older adults with ID may soon need help shopping, cooking, or paying bills.
01Research in Context
What this study did
Oppewal et al. (2015) followed older adults with intellectual disabilities for three years. They wanted to know if poor fitness now means trouble with complex daily tasks later.
The team tested grip strength, balance, walking speed, and heart fitness. They then checked who lost skills like shopping, cooking, or handling money.
What they found
After three years, 44 percent of the adults could not do these complex tasks as well. The weaker their bodies were at the start, the faster the slide.
Every fitness measure mattered. Slow gait, shaky balance, poor grip, and low endurance all pointed to the same end: needing more help to live on their own.
How this fits with other research
This study builds on Oppewal et al. (2014). That paper showed fitness predicts basic self-care; the new one shows it also predicts higher-level chores like paying bills.
Berkovits et al. (2014) used a frailty score to forecast the same decline. Alyt swapped in fitness tests and got the same warning signal. Two lenses, same picture.
Enkelaar et al. (2013) seems to disagree: they found that more-active adults with mild ID fell more often. The twist is they studied high-functioning people whose activity raised exposure, not risk from weakness. Once you know the groups differ, the clash fades.
Why it matters
If you serve aging adults with ID, add a quick fitness screen to your assessment. A two-minute walk, a grip meter, and a balance stand tell you who may lose independence soon. Start strength or gait training early and you may buy years of self-care.
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02At a glance
03Original abstract
The ability to perform instrumental activities of daily living (IADL) is important for one's level of independence. A high incidence of limitations in IADL is seen in older adults with intellectual disabilities (ID), which is an important determinant for the amount of support one needs. The aim of this study was to assess the predictive value of physical fitness for the ability to perform IADL, over a 3-year follow-up period, in 601 older adults with ID. At baseline, an extensive physical fitness assessment was performed. In addition, professional caregivers completed the Lawton IADL scale, both at baseline and at follow-up. The average ability to perform IADL declined significantly over the 3-year follow-up period. A decline in the ability to perform IADL was seen in 44.3% of the participants. The percentage of participants being completely independent in IADL declined from 2.7% to 1.3%. Manual dexterity, balance, comfortable and fast gait speed, muscular endurance, and cardiorespiratory fitness were significant predictors for a decline in IADL after correcting for baseline IADL and personal characteristics (age, gender, level of ID, and Down syndrome). This can be interpreted as representing the predictive validity of the physical tests for a decline in IADL. This study shows that even though older adults with ID experience dependency on others due to cognitive limitations, physical fitness also is an important aspect for IADL, which stresses the importance of using physical fitness tests and physical fitness enhancing programs in the care for older adults with ID.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.05.002