The association of life events and mental ill health in older adults with intellectual disability: results of the wave 3 Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing.
Life events strongly predict mental-health deterioration in older adults with ID—screen for recent events during clinical intake and care planning.
01Research in Context
What this study did
Titlestad et al. (2019) asked older Irish adults with intellectual disability about recent life events. They also recorded who took psychotropic medication and who reported poor mental health.
The team used a cross-sectional survey. They compared event load to mental-health status at one point in time.
What they found
More life events and heavier event burden went hand in hand with worse mental health. The same people were also more likely to be on psychotropic drugs.
The link held for the whole older cohort, not just a subgroup.
How this fits with other research
van Schrojenstein Lantman-de Valk et al. (2006) tracked adults with ID over time and saw negative events predict later behavior problems and depression. Titlestad et al. (2019) now show the same pattern holds after age 65.
Hove et al. (2016) found that loss of relatives and bullying drove depression in working-age adults. The Irish data echo this in seniors, suggesting the risk does not fade with age.
Thomas et al. (2021) surveyed Australians over 60 and also tied adverse events to mental illness. They added physical comorbidities as a co-predictor, something the Irish team did not test.
Lunsky et al. (2011) went one step further and linked the same events to emergency-department crisis visits. Their finding extends the Irish results: life events can hurt mental health and later send clients to the ED.
Why it matters
You already ask about behavior and mood. Add two quick questions: “Have you moved, lost someone close, or had a big upset in the last six months?” If the answer is yes, plan extra coping support and watch for early signs of crisis. This simple screen costs no time and can prevent medication hikes or ED trips down the road.
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02At a glance
03Original abstract
BACKGROUND: Exposures to life events are associated with emotional, psychological and behavioural problems in those with intellectual disability (ID). Older adults with ID may experience different life events given differences in living circumstances, cognitive decline, greater dependency on others and less autonomy. This study examines the relationship of life events and mental ill health in an older ID population in Ireland. METHODS: The study was part of 'The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing'. The frequency of life events was assessed using a 20-item checklist, and the level of stress experienced was assessed using a three-point Likert scale measuring the burden of the life event. The associations of life events with factors associated with mental ill health were measured using a variety of self-report and proxy completed questionnaires. RESULTS: For the study population, 88.1% had been exposed to at least one life event in the preceding 12 months and 64.5% to two or more life events. Frequency and burden of life events were significantly higher in individuals living in institutional settings and in individuals with any current psychiatric condition, increased depressive and anxiety symptoms, challenging behaviour and reported poorer self-rated mental and physical health. More life events were significantly associated with new psychiatric diagnoses as well as initiation and increased dosage of mood stabilising, hypnotic and sedative medications. CONCLUSIONS: Life events are significantly associated with mental ill health in the older ID population. Service providers must focus on limiting the exposure to these events and, in situations where they cannot be avoided, should support and manage individuals compassionately and effectively, prioritising their mental and physical well-being.
Journal of intellectual disability research : JIDR, 2019 · doi:10.1111/jir.12595