The relationship between psychiatric and physical health in elderly people with intellectual disability.
In elders with ID, physical illness predicts dementia, while other mental health problems link only to ID level—so screen the body and the brain together.
01Research in Context
What this study did
Meyer (1999) looked at 134 adults 65-plus who have intellectual disability. The team asked: what predicts dementia and other mental health issues in this group?
They gave full medical exams and IQ tests. They noted who had heart disease, diabetes, or other physical problems.
What they found
Dementia risk rose when the person also had physical illness, smoked, or had lower IQ. Age plus these health problems made dementia more likely.
Other mental health disorders, like depression or anxiety, tied only to lower IQ level. Physical illness did not raise those odds.
How this fits with other research
Dall et al. (1997) saw the same link first: elders with ID plus dementia had more chronic disease and lower daily-living skills. Meyer (1999) adds numbers, showing physical illness is a clear risk factor.
Foti et al. (2015) widened the view in 990 elders. They found anxiety doubled the chance of diabetes. Taken together, physical and mental health problems keep showing up together in this age group.
Hastings et al. (2002) looked at the adults in group homes. They also saw more heart and joint problems with age, but fewer reported risk factors than the general public. The pattern is consistent: older adults with ID carry hidden medical load.
Why it matters
If you serve adults 65-plus with ID, always pair mental health screens with a medical check. Ask about smoking, heart disease, diabetes, and vision or hearing loss. Early treatment of these physical issues may slow cognitive decline. A quick vital-sign and medication review at intake can guide your behavior plan and help the client stay active longer.
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02At a glance
03Original abstract
Elderly people with intellectual disability have high rates of both psychiatric and physical disorders. In the elderly general population, these disorders are known to be associated. Whether such an association exists amongst elderly people with intellectual disability is unclear, but the resolution of this question is of clinical as well as academic importance. Psychiatric and physical assessments were completed on 134 people with intellectual disability aged 65 years and over (93.7% of the ascertained population living in Leicestershire, UK). The relationship between the two disorders was statistically examined. The number of physical disorders, age, level of intellectual disability and smoking status were retained in the logistic regression equation which predicted caseness for dementia in 79.9%. Similar statistical modelling for psychiatric disorders (other than dementia) retained the level of intellectual disability as the only explanatory variable in the equation. These results differ from the elderly general population, but are in keeping with the one previous intellectual disability study. In view of the poor use of general medical services by elderly people with intellectual disability, knowledge of such comorbidity should alert psychiatrists to the need for physical assessments in order to optimize health.
Journal of intellectual disability research : JIDR, 1999 · doi:10.1046/j.1365-2788.1999.43120158.x