Objectives To analyze the relationship between frailty and survival in older people with intellectual disabilities (IDs). Design Population-based longitudinal observational study. Setting Three Dutch care provider services. Participants Individuals with borderline to profound ID aged 50 and older (N = 982). Measurements A frailty index (FI) including 51 health-related deficits was used to measure frailty. Mean follow-up was 3.3 years. The Cox proportional hazards model was used to evaluate the independent effect of frailty on survival. The discriminative ability of the FI was measured using a receiver operating characteristic (ROC) curve. Results Greater FI values were associated with greater risk of death, independent of sex, age, level of ID, and Down syndrome. There was a nonlinear increase in risk with increasing FI value. For example, mortality risk was 2.17 times as great (95% confidence interval (CI) = 0.95-4.95) for vulnerable individuals (FI 0.20-0.29) and 19.5 (95% CI = 9.13-41.8) times as great for moderately frail individuals (FI 0.40-0.49) as for relatively fit individuals (FI <0.20). The area under the ROC curve for 3-year survival was 0.78. Conclusion Although the predictive validity of the FI should be further determined, it was strongly associated with 3-year mortality. Care providers working with people with ID should be able to recognize frail clients and act in an early stage to stop or prevent further decline.

frailty, older people with ID, survival
dx.doi.org/10.1111/jgs.13239, hdl.handle.net/1765/85412
American Geriatrics Society. Journal
Department of General Practice

Schoufour, J.D, Mitnitski, A, Rockwood, K, Evenhuis, H.M, & Echteld, M.A. (2015). Predicting 3-year survival in older people with intellectual disabilities using a frailty index. American Geriatrics Society. Journal, 63(3), 531–536. doi:10.1111/jgs.13239