Autism & Developmental

Care dependence and activities of daily living in relation to ageing: results of a longitudinal study.

Maaskant et al. (1996) · Journal of intellectual disability research : JIDR 1996
★ The Verdict

ADL skills fall early in adults with ID—after 40 for Down syndrome, after 60 for others—while care hours stay flat.

✓ Read this if BCBAs running residential or day programs for adults with ID.
✗ Skip if Clinicians who only serve children or typically-developing adults.

01Research in Context

01

What this study did

Bauman et al. (1996) followed the adults with intellectual disability for six years. All lived in state-run homes in the Netherlands. Staff scored how well each person bathed, dressed, ate, and used the toilet.

The team split the group by age and by diagnosis. They wanted to see who lost daily-living skills first.

02

What they found

After age 60, most residents needed more help with every-day tasks. The drop was steepest in people with Down syndrome; their skills slipped after 40.

Care hours stayed flat until the 70-plus group. In short, bodies aged faster than support plans changed.

03

How this fits with other research

Griffith et al. (2012) extends this picture. They tested fitness in 1,000 older adults with ID. Two-thirds had the strength of someone 20-30 years older. Low fitness likely fuels the ADL slide A et al. saw.

Hsieh et al. (2015) adds context. They found obesity and low activity spike in adults who leave school or move to tighter settings. These social shifts may speed up the age-linked decline.

Nordstrøm et al. (2013) shows one reason Down syndrome declines earlier. Adults with Down syndrome average only 27 minutes a day of brisk movement. Less motion means faster skill loss.

04

Why it matters

If you serve adults with ID, expect daily-living dips sooner than in the general public. Start strength and mobility programs before 40 for Down syndrome and before 60 for other ID. Use the fitness data from M et al. to set baselines. Track ADL every six months so you can add prompts or hours before crisis hits.

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Add a 5-minute chair-to-stand count to your next assessment for clients over 35; use the number to flag who needs a fitness plan before ADL slips.

02At a glance

Intervention
not applicable
Design
other
Sample size
1602
Population
intellectual disability, down syndrome
Finding
negative

03Original abstract

From 1990 to 1993, the University of Limburg and the Pepijn Centre, the Netherlands, have performed a prospective cohort study on ageing and intellectual disability. The key questions of the study were: "To what degree do the level of care dependence and activities of daily living (ADL) differ between age groups, and to what degree do these skills change during the study period (3 years)? Are the changes age related?'. Looking at the changes in time, the results show that the level of care dependence did not change substantially in the sample of 1602 residents of Dutch facilities for people with intellectual disability. Only the oldest residents (70+ years) showed a significant decline in independence. The results also show that the skills of young people with Down's syndrome (< 40 years) did not change substantially, whereas older people with Down's syndrome (40+ years) showed a substantial decrease in ADL-skills. The ADL-skills of the residents with other aetiological diagnoses younger than 60 years of age did not change substantially, while the older residents (60-69 and 70+ years) showed a significant decrease in ADL-functions. The trend between changes in ADL and age in both aetiological groups was statistically significant. Attention is paid to the implications of these findings in the discussion.

Journal of intellectual disability research : JIDR, 1996 · doi:10.1046/j.1365-2788.1996.807807.x