title: Prevalence of older people with intellectual disability in Sweden: a spatial epidemiological analysis.
abstract: BACKGROUND
  The expected increase in longevity of individuals with intellectual disabilities (ID) in many countries of the world is a direct result of medical and social advances, which have also extended the longevity of the general population. It is important to assess the need for social services for people with ID across different administrative levels to ensure sufficient resources are allocated to where they are most needed. This study estimates the annual prevalence of older people with ID from 2004 to 2012 and in different counties and municipalities in Sweden, by sex and age group; identifies proxy indicators related to the care of older people with ID in different counties in 2012 in Sweden and analyses the spatial distribution and clustering of municipalities with a high prevalence of older people with ID.
  
  
  METHODS
  Individuals with ID were identified through the national register based on the Swedish Act concerning Support and Service for Persons with Certain Functional Impairments (the LSS act) and the national death register. This study focuses on older individuals aged 55+ during the period of 2004-2012. The estimated prevalence was calculated at the county and municipality level and plotted on a municipality-level map. Moran's I statistics was used to identify any spatial clustering of municipalities with a large number of individuals with ID.
  
  
  RESULTS
  The prevalence of ID among older individuals aged 55+ in Sweden increased from 2004 to 2012. The prevalence was consistently higher among men, and the gender gap increased slightly in recent years. Age-specific prevalence estimates showed ID to be higher in younger age groups, and the gender gap decreased in older age groups. The prevalence was higher in northern counties in Sweden (over 500 individuals per 100 000 population aged 55+). Higher prevalence areas were clustered in northern municipalities, whereas municipalities with high prevalence of older individuals with ID in the middle and southern regions of Sweden demonstrated a more widespread distribution.
  
  
  CONCLUSIONS
  The existence of clusters of counties with a high prevalence of older individuals with ID necessitates further assessment of how resources have been allocated to different counties and municipalities in Sweden. Investigations of the quality of social services provided to individuals with ID across different counties in Sweden are warranted. It is important to ensure that high quality supports are being provided to older individuals with ID in order to grant them the same right to healthy ageing as their counterparts living without ID throughout their life course.
authors: Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden.|Centre for Demographic and Ageing Research, Umeå University, Sweden.
authors: N
authors: http://orcid.org/0000-0003-0556-1483
authors: N
authors: Ng
authors: Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
authors: M
authors: http://orcid.org/0000-0002-8915-8730
authors: M
authors: Sandberg
authors: Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
authors: G
authors: G
authors: Ahlström
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D062206:Spatial Analysis; D013548:Sweden / Q000453:epidemiology
keywords: Sweden; clustering; developmental disorder; healthy ageing; intellectual disability; learning disability