title: Physical fitness is predictive for a decline in the ability to perform instrumental activities of daily living in older adults with intellectual disabilities: Results of the HA-ID study.
abstract: The ability to perform instrumental activities of daily living (IADL) is important for one's level of independence. A high incidence of limitations in IADL is seen in older adults with intellectual disabilities (ID), which is an important determinant for the amount of support one needs. The aim of this study was to assess the predictive value of physical fitness for the ability to perform IADL, over a 3-year follow-up period, in 601 older adults with ID. At baseline, an extensive physical fitness assessment was performed. In addition, professional caregivers completed the Lawton IADL scale, both at baseline and at follow-up. The average ability to perform IADL declined significantly over the 3-year follow-up period. A decline in the ability to perform IADL was seen in 44.3% of the participants. The percentage of participants being completely independent in IADL declined from 2.7% to 1.3%. Manual dexterity, balance, comfortable and fast gait speed, muscular endurance, and cardiorespiratory fitness were significant predictors for a decline in IADL after correcting for baseline IADL and personal characteristics (age, gender, level of ID, and Down syndrome). This can be interpreted as representing the predictive validity of the physical tests for a decline in IADL. This study shows that even though older adults with ID experience dependency on others due to cognitive limitations, physical fitness also is an important aspect for IADL, which stresses the importance of using physical fitness tests and physical fitness enhancing programs in the care for older adults with ID.
authors.affiliation: Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands; Ipse de Bruggen, P.O. Box 7027, 2701 AA Zoetermeer, the Netherlands. Electronic address: a.oppewal@erasmusmc.nl.
authors.forename: Alyt
authors.initials: A
authors.lastname: Oppewal
authors.affiliation: Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands; Abrona, Amersfoortseweg 56, 3712 BE Huis ter Heide, the Netherlands.
authors.forename: Thessa I M
authors.initials: TI
authors.lastname: Hilgenkamp
authors.affiliation: Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV Groningen, the Netherlands.
authors.forename: Ruud
authors.initials: R
authors.lastname: van Wijck
authors.affiliation: Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
authors.forename: Josje D
authors.initials: JD
authors.lastname: Schoufour
authors.affiliation: Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands.
authors.forename: Heleen M
authors.initials: HM
authors.lastname: Evenhuis
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004314:Down Syndrome / Q000503:physiopathology*; D005260:Female; D005684:Gait; D018737:Hand Strength; D006801:Humans; D008607:Intellectual Disability / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D010807:Physical Endurance; D010809:Physical Fitness; D004856:Postural Balance; D011446:Prospective Studies; D016059:Range of Motion, Articular; D011930:Reaction Time
keywords: Instrumental activities of daily living; Intellectual disabilities; Older adults; Physical fitness