Subgroups associated with lower physical fitness in older adults with ID: results of the HA-ID study.
Older adults with ID who are female, have Down syndrome, or move little start with the lowest fitness, so ease them into activity with extra support.
01Research in Context
What this study did
The team looked at 1,050 older adults with intellectual disability. They wanted to know who starts with the worst fitness.
No exercise program was tested. The study simply sorted people by age, sex, diagnosis, and daily activity level.
What they found
Lowest fitness showed up in women with Down syndrome, severe ID, mobility problems, and little daily movement.
These factors stacked up. One person could have several red flags at once.
How this fits with other research
Griffith et al. (2012) first showed the whole HA-ID group was shockingly unfit. The 2014 paper zooms in and names the people who pull the average down.
Mihaila et al. (2017) later found adults with Down syndrome do almost no active leisure. Their data help explain why this group scores worst on fitness tests.
Laxton et al. (2026) added accelerometers and clocked nearly 8 hours of daily sitting in adults with ID. Low-activity days line up with the low-fitness profile seen here.
Lin et al. (2013) saw the same pattern in Taiwan: Down syndrome plus low education predicts both poor ADL scores and poor fitness. Method and message match across countries.
Why it matters
When you write a health plan, flag clients who are female, have Down syndrome, use a walker, or sit most of the day. Start with short, supported movement breaks and build up slowly. These are the people who need the gentlest entry into exercise and the most caregiver help to stick with it.
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02At a glance
03Original abstract
Although physical fitness is generally very low in older adults with intellectual disabilities (ID), levels may differ across subgroups. It is important to identify which subgroups need to be targeted specifically in physical activity and fitness interventions and reference values. Physical fitness was measured with box-and-block-test, response-time-test, Berg-balance-scale, walking speed, grip strength, 30s-chair-stand, 10 m incremental-shuttle-walking test and the extended modified-back-saver-sit-and-reach-test in a large sample of older adults with ID (n=1050), and subgroups associated with lower physical fitness levels were identified applying multivariate linear regression analyses. Both fixed personal characteristics such as being older, being female, having more severe ID and having Down syndrome and modifiable or preventable factors such as physical activity levels, mobility impairments and a need of more intensive care, are independently associated with lower levels of multiple physical fitness components. This first study identifies subgroups of older adults with ID which require adapted reference values, and subgroups that need to be specifically targeted in fitness promotion programs.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.11.015