Sarcopenia predicts 5-year mortality in older adults with intellectual disabilities

Background: People with intellectual disabilities (ID) have a lower life expectancy than their peers without ID. A contributing factor to the lower life expectancy and early mortality could be sarcopenia: low muscle mass and low muscle function. In the general population, sarcopenia strongly predicts early mortality, but this association is unknown in people with ID. Therefore, this study aims to explore the association between sarcopenia and 5-year mortality in older adults with ID. Methods: In the Healthy Ageing and Intellectual Disabilities (HA-ID) study, the prevalence of sarcopenia was measured at baseline among 884 older adults (≥50 years) with ID. All-cause mortality was measured over a 5-year follow-up period. Univariable and multivariable Cox proportional hazard models were applied to determine the association between sarcopenia (no sarcopenia, pre-sarcopenia, sarcopenia, severe sarcopenia) and early mortality, adjusted for age, sex, level of ID, presence of Down syndrome, and co-morbidity (chronic obstructive pulmonary disease, diabetes type 2 and metabolic syndrome). Results: The unadjusted hazard ratio (HR) for sarcopenia was 2.28 [95% confidence interval (CI) 1.48–3.42], P &lt; 0.001), and 2.40 (95% CI 1.40–4.10, P = 0.001) for severe sarcopenia. When adjusted for age, sex, level of ID, and Down syndrome, sarcopenia (HR = 1.72, 95% CI 1.08–2.75, P = 0.022) and severe sarcopenia (HR = 1.86, 95% CI 1.07–3.23, P = 0.028) were significantly associated with early mortality. When additionally adjusted for co-morbidity, the adjusted HR decreased to 1.62 (95% CI 1.02–2.59, P = 0.043) and 1.81 (95% CI 1.04–3.15, P = 0.035) for sarcopenia and severe sarcopenia, respectively. Conclusion: Sarcopenia is an independent risk factor for early mortality in older adults with ID over a 5-year follow-up period. Our results stress the need to delay the incidence and development of sarcopenia in older adults with ID.</p

COVID-19 en de zorg en ondersteuning aan mensen met verstandelijke beperkingen:alleen samen krijgen de academische werkplaatsen de kennisvragen beantwoord

Een professionele zorgsector kan niet zonder een goed georganiseerde kennisinfrastructuur. Vanuit deze onderkenning gaf het ministerie van VWS in 2017 opdracht aan ZonMw om een programma te ontwikkelen waarmee bestaande Academische Werkplaatsen in de zorg voor mensen met een verstandelijke beperking structurele middelen konden krijgen om het ophalen van vraagstukken uit de praktijk te ondersteunen, hun door de praktijk geïnspireerde wetenschappelijke onderzoek verder uit te bouwen en verder bij te dragen aan de professionaliteit van de zorgpraktijk. Deze Academische Werkplaatsen bundelden hun krachten in de landelijke Associatie van Academische Werkplaatsen Verstandelijke Beperkingen. In het tweede jaar van dit programma kreeg de COVID-19 pandemie het veld in haar greep. Dit artikel beschrijft de inzet van de Associatie van Academische Werkplaatsen Verstandelijke Beperkingen om gezamenlijk de nieuwe kennisvragen, inzichten en ideeën te voorzien van wetenschappelijk onderbouwde antwoorden, gegevens en reflectie, en zodoende een bijdrage te leveren aan de vele inspanningen die het veld levert om in deze volstrekt nieuwe situatie de kwaliteit van zorg en ondersteuning, en daarmee de kwaliteit van leven van mensen met verstandelijke beperkingen, zo goed mogelijk te ondersteunen

COVID-19 en de zorg en ondersteuning aan mensen met verstandelijke beperkingen: alleen samen krijgen de academische werkplaatsen de kennisvragen beantwoord

Een professionele zorgsector kan niet zonder een goed georganiseerde kennisinfrastructuur. Vanuit deze onderkenning gaf het ministerie van VWS in 2017 opdracht aan ZonMw om een programma te ontwikkelen waarmee bestaande Academische Werkplaatsen in de zorg voor mensen met een verstandelijke beperking structurele middelen konden krijgen om het ophalen van vraagstukken uit de praktijk te ondersteunen, hun door de praktijk geïnspireerde wetenschappelijke onderzoek verder uit te bouwen en verder bij te dragen aan de professionaliteit van de zorgpraktijk. Deze Academische Werkplaatsen bundelden hun krachten in de landelijke Associatie van Academische Werkplaatsen Verstandelijke Beperkingen. In het tweede jaar van dit programma kreeg de COVID-19 pandemie het veld in haar greep. Dit artikel beschrijft de inzet van de Associatie van Academische Werkplaatsen Verstandelijke Beperkingen om gezamenlijk de nieuwe kennisvragen, inzichten en ideeën te voorzien van wetenschappelijk onderbouwde antwoorden, gegevens en reflectie, en zodoende een bijdrage te leveren aan de vele inspanningen die het veld levert om in deze volstrekt nieuwe situatie de kwaliteit van zorg en ondersteuning, en daarmee de kwaliteit van leven van mensen met verstandelijke beperkingen, zo goed mogelijk te ondersteunen

Development and validation of a shortened and practical frailty index for people with intellectual disabilities

Background: There is no widely used instrument to detect frailty in people with intellectual disabilities (IDs). We aimed to develop and validate a shorter and more practical version of a published frailty index for people with IDs. Method: This study was part of the longitudinal ‘Healthy Ageing and Intellectual Disability’ study. We included 982 people with IDs aged 50 years and over. The previously developed and validated ID-Frailty Index consisting of 51 deficits was used as the basis for the shortened version, the ID-FI Short Form. Content of the ID-FI Short Form was based on statistics and clinical and practical feasibility. We evaluated the precision and validity of the ID-FI Short Form using the internal consistency, the correlation between the ID-FI Short Form and the original ID-Frailty Index, the agreement in dividing participants in the categories non-frail, pre-frail and frail, and the association with survival. Results: Seventeen deficits from the original ID-Frailty Index were selected for inclusion in the ID-FI Short Form. All deficits of the ID-FI Short Form are clinically and practically feasible to assess for caregivers and therapists supporting people with ID. We showed acceptable internal consistency with Cronbach's alpha of 0.75. The Pearson correlation between the ID-Frailty Index and the ID-FI Short Form was excellent (r = 0.94, P < 0.001). We observed a good agreement between the full and short forms in dividing the participants in the frailty categories, with a kappa statistic of 0.63. The ID-FI Short Form was associated with survival; with every 1/100 increase on the ID-FI Short Form, the mortality probability increased by 7% (hazard ratio 1.07, P < 0.001). Conclusion: The first validation of the ID-FI Short Form shows it to be a promising, practical tool to assess the frailty status of people with ID

Development and validation of a shortened and practical frailty index for people with intellectual disabilities

BACKGROUND: There is no widely used instrument to detect frailty in people with intellectual disabilities (IDs). We aimed to develop and validate a shorter and more practical version of a published frailty index for people with IDs. METHOD: This study was part of the longitudinal 'Healthy Ageing and Intellectual Disability' study. We included 982 people with IDs aged 50 years and over. The previously developed and validated ID-Frailty Index consisting of 51 deficits was used as the basis for the shortened version, the ID-FI Short Form. Content of the ID-FI Short Form was based on statistics and clinical and practical feasibility. We evaluated the precision and validity of the ID-FI Short Form using the internal consistency, the correlation between the ID-FI Short Form and the original ID-Frailty Index, the agreement in dividing participants in the categories non-frail, pre-frail and frail, and the association with survival. RESULTS: Seventeen deficits from the original ID-Frailty Index were selected for inclusion in the ID-FI Short Form. All deficits of the ID-FI Short Form are clinically and practically feasible to assess for caregivers and therapists supporting people with ID. We showed acceptable internal consistency with Cronbach's alpha of 0.75. The Pearson correlation between the ID-Frailty Index and the ID-FI Short Form was excellent (r = 0.94, P < 0.001). We observed a good agreement between the full and short forms in dividing the participants in the frailty categories, with a kappa statistic of 0.63. The ID-FI Short Form was associated with survival; with every 1/100 increase on the ID-FI Short Form, the mortality probability increased by 7% (hazard ratio 1.07, P < 0.001). CONCLUSION: The first validation of the ID-FI Short Form shows it to be a promising, practical tool to assess the frailty status of people with ID

Associations between physical fitness and cardiovascular disease in older adults with intellectual disabilities: Results of the Healthy Ageing and Intellectual Disability study

Background: Reduced physical fitness is a cardiovascular disease (CVD) risk factor in the general population. However, generalising these results to older adults with intellectual disabilities (ID) may be inappropriate given their pre-existing low physical fitness levels and high prevalence of co-morbidities. Therefore, the aim of this study is to investigate the difference in physical fitness between older adults with ID with and without CVD. Method: Baseline data of a cohort of older adults with borderline to profound ID (HA-ID study) were used (n = 684; 61.6 ± 8.2 years; 51.3% male). CVD status (coronary artery disease, heart failure, stroke) was obtained from medical files. Cardiorespiratory fitness (10-m incremental shuttle walking test), comfortable and fast gait speed (over 5 m distance) and grip strength (hand dynamometer) were measured. Multivariable linear regression models were used to investigate the association between these physical fitness components and the presence of CVD, adjusted for participant characteristics. Results: Of the 684 participants 78 (11.4%) had CVD. Participants with CVD scored lower on cardiorespiratory fitness (−81.4 m, P = 0.002), comfortable gait speed (−0.3 km/h, P = 0.04) and fast gait speed (−1.1 km/h, P = 0.04). No significant differences were found for grip strength (−0.2 kg, P = 0.89). Conclusions: Older adults with CVD had significantly lower physical fitness levels than those without CVD, except for grip strength. Longitudinal research is needed to investigate causality