The impact of frailty on care intensity in older people with intellectual disabilities.
A short frailty index predicts future care needs in older adults with ID, giving you time to line up extra support.
01Research in Context
What this study did
The team tracked 676 adults with intellectual disability who were 50 or older. They used a 51-item frailty index at the start and noted how much care each person needed three years later.
The goal was simple: see if early frailty scores predict later care levels.
What they found
People with higher baseline frailty scores needed markedly more help after three years. The link held even after the researchers ruled out age, sex, and other health issues.
In short, the index works as an early warning system for future care needs.
How this fits with other research
Carretti et al. (2013) had already shown that the Vienna Frailty Questionnaire gives reliable scores in the same population. Berkovits et al. (2014) moved the field forward by proving those scores actually forecast later support, not just describe current health.
Robertson et al. (2013) reported that older adults with ID fall about once per person each year. The new study adds a practical layer: use a quick frailty screen to spot the people most likely to fall and to need extra help soon.
Oppewal et al. (2013) found balance scores in this group match adults 20 years older. Together, the papers paint a clear picture: adults with ID age faster, so you should assess frailty early and plan services before crises hit.
Why it matters
You can add the 51-item index to annual health checks. It takes minutes and tells you who will need more staffing, therapy, or home mods in the next few years. Share the score with families and funders to justify support before falls or hospital trips occur.
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02At a glance
03Original abstract
Frailty appears to develop earlier and is more severe in people with intellectual disabilities compared to the general population. The high prevalence of frailty may lead to an increase in care intensity and associated health care costs. Therefore a longitudinal observational study was conducted to determine the effect of frailty on care intensity. The association between frailty and care intensity at baseline and follow-up (3 years later) was assessed. Furthermore, the ability of the frailty index to predict an increase in care intensity after 3 years was evaluated. This study was part of the Dutch 'Healthy aging and intellectual disabilities' (HA-ID) study. Frailty was measured at baseline with a frailty index that included 51 health-and age-related deficits. For all participants information on care intensity in seven steps was available, based on long term care indications under the Act on Exceptional Medical Expenses (AWBZ)--a law that finances specialized long-term care. 676 participants (50 years and over) with ID were included in the final analysis. In 26% of the participants, care intensity had increased during the follow-up period. Increased care during the follow-up was related to a high frailty index score at baseline, independent of gender, age, level of ID and the presence of Down syndrome (p = 0.003). After exclusion of ADL and IADL items, the frailty index remained significantly related with increasing care intensity during follow-up (p = 0.007). Our results underline that screening instruments for early detection of frailty and effective interventions are required to limit the burden of frailty for individuals and caregivers, but also to limit health care utilization.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.08.006