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Older adults with intellectual disability are at increased risk of a wide range of health problems. Hitherto, methods to assess these problems have been healthcare-professional-led and largely based on traditional medical models. Following a literature review and focus group work we produced a user-led health assessment that was feasible and acceptable. The assessment was administered to 57 adults with a wide range of intellectual disability aged 10 years and over, living in the community. The assessment took a median of 21 minutes to administer and covered user-led themes of participation/ability, nutrition and hygiene/self-care. A principal component representing a user-led general health measure correlated positively with the number of health problems (ρ = 0.54, p < 0.001) and the number of drugs (ρ = 0.55, p < 0.001). Further studies using such user-led assessments are needed to assess whether they can have a wider application. [ABSTRACT FROM AUTHOR]