Search

Background: Although there is no strict definition of frailty, it is generally accepted as a state of high vulnerability for adverse health outcomes at older age. Associations between frailty and mortality, dependence, and hospitalization have been shown. We measured the frailty level of older people with intellectual disabilities (ID). Furthermore variation in gender, age, and level of ID were identified. Results were compared to a frailty study in the general European population. Methods: This research elaborates on a large cross-sectional study: Healthy Ageing with Intellectual Disability (HA-ID). Nine hundred-eighty-two men and women (greater than or equal to 50yr) with ID were included. Based on the collected data, we developed a frailty index with 51 health-related deficits, and calculated a frailty index score between 0 and 1 for each individual. Deficits included physical, social and psychological problems. Results: The mean frailty index score was 0.27 (standard deviation 0.13). Frailty was positively correlated with age (r = 0.297, p less than 0.001). More severe ID was associated with higher frailty scores (beta = 0.440, p less than 0.001). The upper limit of the FI was 0.69, which was consistent for all age categories. Conclusion: As people with ID are getting older, the question whether additional years are spent in good health becomes salient. Here, people with ID over age 50 had frailty scores similar to most elderly people over 75y. Future research is needed to confirm if frail elderly people with ID have an increased risk of adverse health outcomes. (Contains 4 figures and 3 tables.)

Purpose: To analyze cognitive changes in relation to mortality with the use of a multistate transition model., Methods: In a prospective cohort study of Japanese Americans living in King County, WA, study (n = 1985) cognitive states were defined as the errors in the Cognitive Abilities Screening Instrument score. Transition probabilities were modeled by the use of a modified Poisson distribution with the Poisson mean and mortality dependent on the cognitive state and covariates., Results: During an 8-year follow-up, 21.5% died (95% confidence interval [95% CI], 19.3-23.7), 26.6% experienced cognitive decline (95% CI, 24.2-29.1), and 51.9% remained stable or improved cognitively (95% CI, 49.2-54.6). In multivariable analyses, improvements were notably more likely to occur among younger, more-educated people and in women. Older age, male sex, and less education were each significantly related to mortality., Conclusions: A multistate transition model can be used to estimate the impact of covariates on the individual probabilities of cognitive improvement, stability, decline, and death. This approach can have advantages for considering how interventions might work on patterns of cognitive change over time, especially if factors associated with the prevention of decline are also associated with risk of death., (Copyright 2010 Elsevier Inc. All rights reserved.)