The Intellectual Disability Mortality Disadvantage: Diminishing With Age?

Landes (2017) looked at death records for thousands of adults with and without intellectual disability (ID).

The team tracked how big the mortality gap was at each age group, from 25 up to 85-plus.

Adults with ID still die sooner, but the gap shrinks as both groups get older.

The narrowing is strongest in women: by the oldest ages, the extra risk is almost gone.

Eggleston et al. (2018) extends the story. They show that once adults with ID hit 50, having four or more chronic illnesses or taking five-plus meds doubles the chance of dying within five years. The age-gap shrink does not mean medical risk disappears; it just means the general population is also getting sicker.

Lin et al. (2011) is the predecessor warning. Managers already knew people with ID age earlier, but services were not ready. Landes (2017) now gives numbers that justify those early alarms.

Pitchford et al. (2019) seems to clash: they find higher hospital readmissions in older adults with ID for some body systems. If the mortality gap is closing, why more re-hospitalizations? The answer is method: Landes (2017) counts death, while A et al. count return visits. More trips to the hospital can happen even if ultimate survival evens out.

You can stop assuming every older client with ID is automatically at extreme end-of-life risk. Use the extra years to plan: teach health self-advocacy, schedule chronic-condition reviews, and push for lower pill counts when possible. The window for quality-of-life gains is wider than we once thought.