Prevalence and associated factors of problem behaviours among older adults with intellectual disabilities in Ireland.
Problem behaviors stay common in older Irish adults with ID and ride along with heavy psychotropic use—so audit meds and watch for psychiatric red flags.
01Research in Context
What this study did
O'Dwyer et al. (2018) asked a simple question: how many older Irish adults with intellectual disability show problem behaviors?
They mailed surveys to carers of adults over 65 with ID. The survey listed common behaviors like aggression, self-injury, and repetitive actions.
Carers ticked boxes and added notes about medication, diagnoses, and life events. The team then looked for patterns.
What they found
Over half of the older adults showed at least one problem behavior. That is about the same rate seen in younger adults with ID.
The behaviors were not random. They clustered with severe ID, living in staffed homes, recent life events, psychiatric diagnosis, and use of psychotropic drugs.
How this fits with other research
Roane et al. (2001) saw the same 60% rate in working-age UK adults. Claire’s team extends that picture into old age. The link to psychotropics and ID severity repeats across both studies.
McCarron et al. (2013) used the same Irish cohort to show that 71% of adults over 40 already carry two or more chronic conditions. Claire adds the behavioral side: multimorbidity and behavior problems travel together.
Garwood et al. (2021) found 54% of German adults with ID on psychotropic meds, tied to challenging behavior. Claire confirms the circle: drugs, diagnosis, and behavior all rise together in older age.
Green et al. (1999) warned that crisis behaviors persist into later life. Claire gives numbers: the crises do not fade; they stay at mid-life levels.
Why it matters
If you serve older adults with ID, expect problem behaviors in every second client. Screen for psychiatric diagnoses and review psychotropic meds at each visit. Track life events like bereavement or placement changes; they often trigger new behaviors. Build behavior plans now, before crises push teams toward more drugs.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Pull your oldest ID clients’ med lists—flag any antipsychotic started after a behavior crisis and request a review.
02At a glance
03Original abstract
A growing number of adults with intellectual disabilities (ID) are reaching old age, however, little is known about epidemiology of problem behaviours (PBs) in this population. The aim was to identify the prevalence and associated factors of PBs among older adults with ID in Ireland. Data was generated from Wave 2 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA), a nationally representative sample of adults with ID aged ≥40. Data on PBs was available for 683 (98.3%) of individuals. Over half (53%; n = 362) reported displaying any PB (verbal aggression, physical aggression, destruction, self-injury, or "other" PB). Multivariate analyses indicated PBs were independently associated with moderate or severe/profound ID, living in a community group home or residential centre, experiencing a greater number of life events in the last year, taking psychotropic medication, and reporting a doctor's diagnosis of a psychiatric problem. A considerable number of older adults with ID in Ireland display PBs, which may hinder their opportunities to engage in community based activities and form meaningful social connections. High rates of psychotropic medication and doctor's diagnosis of psychiatric conditions and their associations with PBs were highlighted. Future research should examine mechanisms underlying these linkages.
Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.05.007