(Instrumental) activities of daily living in older adults with intellectual disabilities.
Strong legs predict independence in aging clients with ID better than IQ scores.
01Research in Context
What this study did
The team looked at 989 older adults with intellectual disability in the Netherlands.
They asked: what predicts how well these adults handle daily tasks like dressing, cooking, and shopping?
Instead of only checking IQ scores, they measured mobility, health, and living setup.
What they found
Mobility beat IQ level as the top predictor of daily-life skills.
Adults who could walk faster and stand longer scored higher on both basic and complex chores.
Even people with severe ID kept up self-care if their legs stayed strong.
How this fits with other research
Bauman et al. (1996) saw ADL skills drop after age 60, especially in Down syndrome. The 2011 data agree, but add that the drop ties more to walking speed than to ID level.
Lin et al. (2013) found the same link in Taiwan: half of adults over 45 stayed fully independent, and low Barthel scores clustered in people with poor mobility.
Griffith et al. (2012) showed most adults with ID have fitness like people 20-30 years older. That low fitness gives a body-based reason why mobility, not IQ, drives daily skills.
Laxton et al. (2026) added that residents who need more ADL help sit almost eight hours a day. Less walking means weaker legs, which loops back to lower ADL scores seen in 2011.
Why it matters
Stop guessing independence from case files. Watch the person move. If they shuffle or rise slowly, add leg-strength drills, balance games, or short hallway walks before teaching buttoning or cooking. Better legs buy more years of self-care than another tabletop matching task.
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02At a glance
03Original abstract
Daily living skills are important to ageing adults with intellectual disabilities (ID). The purpose of this study was to investigate the level of these skills in older adults with ID and to investigate the influence of gender, age, level of ID and mobility on these skills. Daily living skills were measured with the Barthel Index (for Activities of Daily Living, ADL) and the Lawton IADL scale (for Instrumental Activities of Daily Living, IADL) in 989 adults with ID aged 50 years and over living in community-based and institutional settings. Descriptives were presented by categories of gender, age, level of ID and mobility. Regression analysis was used to investigate the influence of these variables on total and item scores of ADL and IADL questionnaires. ADL and IADL scores in older adults with ID are comparable to those of vulnerable patient groups. Total ADL score was mainly determined by mobility, while total IADL score was mainly determined by level of ID. Of all 18 separate items of these questionnaires, 11 were determined more by mobility than level of ID. The Barthel Index and Lawton IADL scale are recommended for future use in research and clinical practice in this group. This study stresses the need to support mobility older adults with ID as much as possible, in order to optimize independency in this group.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.04.003