Predicting disabilities in daily functioning in older people with intellectual disabilities using a frailty index.
A short frailty checklist predicts who with ID will lose daily skills years later.
01Research in Context
What this study did
The team followed 703 adults with intellectual disability aged 50 and up for three years.
At the start they filled a 34-item frailty index: weight loss, fatigue, slow walk, weak grip, low activity, plus disease count.
They then checked who later needed help with bathing, cooking, shopping, climbing stairs.
What they found
People with the highest frailty scores at baseline were three times more likely to lose daily-living skills.
The same group also showed steeper drops in mobility, like walking 10 steps unaided.
Frailty predicted decline even after the researchers controlled for age, sex, and ID level.
How this fits with other research
Dall et al. (1997) saw the same downward slide, but only in clients who already had dementia. The new study shows frailty flags risk in the broader older-ID population, dementia or not.
Choi et al. (2020) found that needing ADL support raises fall risk; D et al. now trace that need back to early frailty, linking the two papers into one care pathway.
Su et al. (2008) used memory tests to forecast daily skills, while D et al. use a quick nurse checklist. Both work, so you can pick the tool that fits your setting.
Why it matters
You now have a five-minute frailty screen that spots which clients will likely lose independence within three years. Start using it at 50, not 65. Pair results with preventive exercise, nutrition, and fall-proofing before decline shows up in data or incident reports.
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02At a glance
03Original abstract
Frailty is a state of increased vulnerability to adverse health outcomes compared to others of the same age. People with intellectual disabilities (ID) are more frequently and earlier frail compared to the general population. Frailty challenges much of health care, which will likely further increase due to the aging of the population. Before effective interventions can start, more information is necessary about the consequences of frailty in this, already disabled, population. Here we report whether frailty predicts disabilities in daily functioning. Frailty was measured with a frailty index (FI). At baseline and follow-up activities of daily living (ADL), instrumental activities of daily living (IADL) and mobility were collected by informant report. For 703 older people with ID (≥50 yr) baseline and follow-up measures were known. Multivariate linear regression models were used to predict ADL, IADL and mobility at follow-up. The FI was significantly associated with disabilities in daily functioning independent of baseline characteristics (age, gender, level of ID, Down syndrome) and baseline ADL, IADL or mobility. The FI showed to be most predictive for those with relative high independence at baseline. These results stress the importance for interventions that limit the progression of frailty and, thereby, help to limit further disability.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.05.022