RESUMEN
BACKGROUND: The health status and health needs of adults with intellectual disability (ID) change with advancing age, and are often accompanied by difficulties with vision, hearing, mobility, stamina and some mental processes. AIM: The present study collected health status information on a large cohort of adults with ID aged > or = 40 years living in small group, community-based residences in two representative areas of New York State, USA. METHOD: Adult group home residents with ID aged between 40 and 79 years (n = 1371) were surveyed to determine their health status and patterns of morbidity. RESULTS: Most subjects were characterized as being in good health. The frequency of cardiovascular, musculoskeletal and respiratory conditions, and sensory impairments increased with age, while neurological, endocrine and dermatological diseases did not. Psychiatric and behavioural disorders declined with increasing age, at least through 70 years of age. Although most conditions increased with age, their frequency varied by sex and level of ID. Frequencies of age-related organ system morbidity were compared to data from the National Health and Nutrition Evaluation Survey III. It was found that adults with ID had a lower overall reported frequency of cardiovascular risk factors, including hypertension and hyperlipidaemia, and adult-onset diabetes. Inconsistencies with mortality data among older adults with ID were observed (which showed equal if not greater prevalence of deaths as a result of cardiovascular disease and cancer). CONCLUSION: These results suggest that either a cohort effect is operating (i.e. contemporary populations are healthier than previous populations), or that there may be under-recognition of select risk factors and diseases.
Asunto(s)
Servicios de Salud/estadística & datos numéricos , Estado de Salud , Personas con Discapacidades Mentales/estadística & datos numéricos , Adulto , Anciano , Envejecimiento , Estudios de Cohortes , Femenino , Hogares para Grupos , Humanos , Masculino , Persona de Mediana Edad , New York , RiesgoRESUMEN
The aim of the present study was to identify the age correlates of behavioural crises in adults with intellectual disability (ID) living in the community. The cohort consisted of 185 clients (IQ < 70), ranging in age from 20 to > 70 years, who were referred to a crisis intervention programme specializing in services to individuals with dual diagnosis over a 7-year period. A retrospective cross-sectional analysis of historical and contemporaneous variables was completed. Referrals for crisis intervention were not related to the age of the client Aggression and non-compliant behaviour occurred with similar frequency in all age groups. Other behaviours, including withdrawal, self-injury, stereotypy and symptoms of psychiatric disorders, occurred less often in older clients. Severity of ID affected the pattern of behavioural crises that resulted in referral. The results suggest that people with ID residing in community settings still experience behavioural crises as they grow older. Confirmation of the trends reported in the present study might signal a need for accelerating the development of comprehensive age-span community mental health and behavioural supports.
Asunto(s)
Intervención en la Crisis (Psiquiatría) , Discapacidad Intelectual/psicología , Adulto , Anciano , Envejecimiento/fisiología , Estudios de Cohortes , Servicios Comunitarios de Salud Mental , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/etiología , Trastornos Mentales/psicología , Persona de Mediana Edad , Derivación y Consulta , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
INTRODUCTION: Relocation effects in the elderly have been a topic of gerontologic research for many years. Prior research, however, has focused on individuals who could make a cognitive appraisal of the relocation process. With a greater prevalence of cognitive impairments and/or psychiatric illnesses in long-term care residents, research is needed to clarify the impact of relocation on these individuals. OBJECTIVE: The purpose of this study was to determine how intrainstitutional relocation affects behavior and psychosocial functioning in residents with and without cognitive, mood, and/or psychotic disorders. METHOD: This prospective study followed 78 residents being relocated intrainstitutionally in a health-related facility that was undergoing major renovations. Medical and nursing information was collected at 1 month pre-move and at 1 and 3 months post-move. Five areas of behavioral and psychosocial functioning (self-care, disoriented behavior, depressed/anxious mood, irritable behavior, and withdrawn behavior) were assessed using the Multidimensional Observation Scale for Elderly Subjects (MOSES). RESULTS: A significant increase was seen in the number of medical visits (p = .04) from time of relocation to 1 month post-move. The groups diagnosed with mood disorder and psychotic disorder had a statistically significant weight loss (p = .04) between 1 month pre-move and 1 month post-move. The study revealed an increase in the number of residents who fell immediately after relocation, but the increase did not reach statistical significance (p = 12). Residents who fell after relocation had resided at the facility for a longer time than the remainder of the sample (p = .08). Residents with a diagnosis of cognitive impairment showed a statistically significant difference in self-care (p = 0.01) and withdrawn behavior (p = 0.01) at 3 months post-move. Extensive relocation preparation and support may have been the main contribution to diminishing the stress of relocation over time and across diagnostic categories.