Service use and cost of mental disorder in older adults with intellectual disability.
BACKGROUND
The cost of caring for people with intellectual disability currently makes up a large proportion of healthcare spending in western Europe, and may rise in line with the increasing numbers of people with intellectual disability now living to old age.


OBJECTIVE
To report service use and costs of older people with intellectual disability and explore the influence of sociodemographic and illness-related determinants.


METHODS
We collected data on receipt and costs of accommodation, health and personal care, physical as well as mental illness, dementia, sensory impairment and disability in a representative sample of adults with intellectual disability aged 60 years and older (n = 212).


RESULTS
The average weekly cost in GBP per older person was 790 pounds (41,080 pounds per year). Accommodation accounted for 74%. Overall costs were highest for those living in congregate settings. Gender, intellectual disability severity, hearing impairment, physical disorder and mental illness had significant independent relationships with costs. Mental illness was associated with an additional weekly cost of 202 pounds.


CONCLUSIONS
Older adults with intellectual disability comprise about 0.15-0.25% of the population of England but consume up to 5% of the total personal care budget. Interventions that meet needs and might prove to be cost-effective should be sought.
Strydom
Andre
A
Department of Mental Health Sciences, University College London Medical School, and Camden and Islington Foundation NHS Trust, London, UK. a.strydom@ucl.ac.uk
Romeo
Renee
R
Perez-Achiaga
Natalia
N
Livingston
Gill
G
King
Michael
M
Knapp
Martin
M
Hassiotis
Angela
A
D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000706:statistics & numerical data; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008607:Intellectual Disability / Q000191:economics* / Q000628:therapy; D008131:London; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000628:therapy; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales