Evenhuis Heleen, Schoufour Josje, Echteld Michael
Erasmus University Medical Center, Intellectual Disability Medicine, Department General Practice, Rotterdam, The Netherlands.
Dev Disabil Res Rev. 2013;18(1):17-21. doi: 10.1002/ddrr.1124.
Frailty is increasingly being recognized as a relevant health measure in older populations, associated with an increased risk of adverse health outcomes and care dependency. Because it is generally perceived that people with intellectual disabilities are "old" from age 50 onwards, frailty research in this group might lead to an understanding of factors, contributing to this perception. The development since the 1990s of conceptual and operational definitions of frailty has resulted in different approaches: biological (phenotype), multidimensional, and non-specific deficit accumulation. All approaches consider disability a consequence rather than a cause of frailty. This may be different for long-disabled populations, which would have consequences for validity of frailty measures. First research shows that the different approaches are applicable to study populations with intellectual disabilities as well. Frailty as defined by both the phenotypic and deficit accumulation approach appears to develop considerably earlier and is more severe in people with intellectual disabilities than in the general older population, supporting the notion of early aging. Before any clinical implications can be outlined, health outcomes (validity), causes, and prevention of frailty should be investigated.
衰弱日益被视为老年人群中一项重要的健康指标，与不良健康结局和护理依赖风险增加相关。由于人们普遍认为智力残疾者从50岁起就“步入老年”，对该群体的衰弱研究可能有助于理解导致这种认知的因素。自20世纪90年代以来，衰弱的概念性和操作性定义不断发展，产生了不同的方法：生物学（表型）、多维度和非特异性缺陷积累。所有方法都将残疾视为衰弱的结果而非原因。对于长期残疾人群体而言，情况可能有所不同，这将对衰弱测量的有效性产生影响。初步研究表明，不同方法也适用于对智力残疾研究人群的研究。与表型和缺陷积累方法所定义的衰弱相比，智力残疾者的衰弱似乎出现得更早，且更为严重，这支持了早衰的观点。在概述任何临床意义之前，应先研究衰弱的健康结局（有效性）、病因和预防措施。
