A structured physical activity and fitness programme for older adults with intellectual disabilities: results of a cluster-randomised clinical trial.
Three staff-led workouts a week for eight months can give older adults with ID small but real boosts in strength, heart health, and thinking skills.
01Research in Context
What this study did
Laposa et al. (2017) ran a cluster-randomized trial in day and residential services for older adults with intellectual disability. Staff led three group exercise sessions each week for eight months. The program wove in behaviour-change tools like goal setting, self-monitoring, and praise.
Sites were randomized to the fitness program or to usual care. Researchers tracked activity levels, strength, heart-health markers, and thinking skills.
What they found
The exercise group posted small but real gains in physical activity, muscle strength, and cardiovascular markers compared with controls. Cognitive scores also inched up. Dropout was notable, yet benefits remained at the end of the trial.
How this fits with other research
Pett et al. (2013) tested a 12-week recreation program for obese young adults with ID. They saw quick, small gains in weight and blood pressure, but the benefits faded by three months. Laposa et al. (2017) kept the program going eight months and saw lasting change, suggesting longer programs may lock in gains.
Danon et al. (2025) added cooking lessons to exercise for young adults and kept 95 % of participants. Laposa et al. (2017) had more dropouts, hinting that mixing skills training with fitness might boost staying power.
van Herwaarden et al. (2025) used the same cluster-RCT design for Active Support in residential homes. Both studies show that staff-led, setting-wide programs can nudge adaptive living skills in adults with ID.
Why it matters
If you support older adults with ID, schedule three staff-led activity blocks per week and fold in simple behaviour-change tactics like step goals and high-fives. Run the program at least six months to give small strength and thinking gains a chance to stick. Pair exercise with a fun skill component if you need better attendance.
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02At a glance
03Original abstract
BACKGROUND: The physical activity level of older adults with intellectual disabilities (ID) is extremely low, and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people. A physical activity programme, including an education programme, was developed for older adults with ID using behaviour change techniques. The programme aimed at improving or maintaining adequate levels of physical activity (primary outcome measure) and motor fitness, cardio respiratory fitness, morphologic and metabolic fitness, activities of daily living, cognitive functioning and depressive symptoms (secondary outcome measures). METHOD: The programme's efficacy was evaluated in a cluster-randomised clinical trial among people aged 43 years and over with mild-moderate levels of ID. Five day-activity centres were randomised to the participation group. In these centres, 81 older adults participated in groups of 8 to 10 in the programme, three times a week during 8 months. The programme was executed by physical activity instructors and staff of day-activity centres. Five other day-activity centres were randomised to the control group; 70 older adults in these centres received care as usual. The generalised linear model with mixed effects was used to test the programme's effectiveness. RESULTS: Significant effects were found on physical activity, muscle strength, systolic and diastolic blood pressure, serum cholesterol level and cognitive functioning, in favour of the programme's participants. No significant improvements were found on balance, serum glucose, weight, waist circumference, walking speed, mobility, depression or instrumental activities of daily living. CONCLUSIONS: The physical activity and fitness programme has established small but significant effects in this sample, but generalising the findings to other settings is difficult due to significant participant dropout. Implementation of evidence-based physical activity programmes among older adults with ID is recommended. Further research is needed to investigate the effectiveness of physical activity on daily life functioning and the development on chronic diseases in the long run.
Journal of intellectual disability research : JIDR, 2017 · doi:10.1111/jir.12267