Abstract
Attention to disease and risk factor management is increasingly a feature of people with intellectual disability (ID) as an augmented life expectancy also exposes a growing number of age-related diseases. An additional concern is little attention to date to physical activity, nutrition, access to social support and other personal health choices and to environmental issues such as the impact of access to social support and the implications of individual’s living arrangements. Method: Using a sample of 753 persons with ID from the intellectual disability supplement to the Irish longitudinal study on ageing (IDS-TILDA), forty three variables were grouped into environmental, predisposing, enabling, need and personal health choices clusters and hierarchical ordinary least squares regression examined the contribution of environmental, enabling, predisposing, need and all combinations of the sets of variables to personal health choices. Findings: Almost 32% of variance was explained primarily by need variables. Most significant relationships were with meeting up with family and friends (environmental), age, rating of health and worries about getting older (predisposing), having public health insurance and nursing who come into the home (enabling) and presence of stroke, chronic constipation, functional limitations, high assistance needs with activities of daily living (need). Discussion: Taken together, the groupings of variables from the Anderson Model explained a modest amount of variance in the pursuit of positive personal health choices by people with ID. More work is clearly needed in developing evidence-based interventions and strategies, and in understanding the relationship between positive personal health choices of people with ID and health outcomes.
Highlights
Estimates suggest that life expectancy for people with an intellectual disability (ID) have increased from an average 18 years in 1930, to 59 years in 1970, to 66 years in 1993, with projected continued growth to eventually match life expectancy of the general population [1]
Sample: The sample was randomly selected from Ireland’s National Intellectual Disability Database (NIDD) which collects information on 26,000 people registered with all levels of ID and in a full range of residential circumstances, eligible for or receiving services [29]
International studies have provided clues that adults with ID, older adults have a greater variety of health care needs compared to those of the same age and gender in the general population [9,25]
Summary
Estimates suggest that life expectancy for people with an intellectual disability (ID) have increased from an average 18 years in 1930, to 59 years in 1970, to 66 years in 1993, with projected continued growth to eventually match life expectancy of the general population [1]. By 2020 the number of persons with ID aged over 65 is projected to double from 1990 estimates [2]. It remains to be definitively established whether for most older adults with ID those extended years are healthy or unhealthy [3]. Attention to disease and risk factor management is increasingly a feature of people with ID as an augmented life expectancy exposes a growing number of persons with ID to age-related diseases. Available data raises that individuals with ID have a greater variety of health care needs compared to those of the same age and gender in the general population [9, OPEN ACCESS An additional concern is little attention to date to physical activity, nutriation, access to social support and other personal health choices demonstrated to improve longevity [4,5] and to environmental issues such as the impact of access to social support and the implications of individual’s living arrangements [6,7,8].
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