ANU Medical School, Australian National University, Australia.
Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
J Intellect Disabil Res. 2021 Jun;65(6):535-547. doi: 10.1111/jir.12825. Epub 2021 Mar 30.
The progressive increase in life expectancy of people with intellectual disability (ID) has resulted in enhanced survival into old age and has also seen a growth in research on both lifelong and emerging ageing-related health issues. Health issues amongst provider-supported adults have been previously studied, but these studies have not always included older community-dwelling adults with ID.
A study examining the extent of mental health of 391 community-dwelling adults with ID age 60 and older in both metropolitan and rural areas of two East Coast Australian states was undertaken using a cross-sectional survey. Examined were a range of demographic (age, sex, living arrangements, employment and socio-economic status) and life (co-morbidities, adverse life events and social support) factors. Data were parsed by two age groupings (60-65: n = 234 and >65: n = 157).
Findings revealed that older community-dwelling adults with ID have many of the same mental health disorders as do other ageing people, with the exception of significant psychiatric disorders often associated with older age. Over a third (35%: n = 137) reported some one or more mental health disorders. Age, sex, location (rural or urban), financial hardship, social support or type of living arrangement were not statistically significant as risk factors for poor mental health. However, employment status was a clear predictor. Stepwise regression models showed a strong association between mental ill-health and adverse life events and between mental ill-health and multiple physical co-morbidities.
The cross-sectional nature of the study limits causal inference. The cumulative effect of chronic health conditions and adverse life events cannot be prevented retrospectively. However, greater awareness amongst both health professionals and care staff that older adults with ID have a high likelihood of significant and/or repeated traumas and need better health care to limit physical co-morbidity may assist in providing support that is better tailored to individual needs in older age to reduce the burden of mental ill-health.
智障人士（ID）的预期寿命不断延长，不仅使他们能更长寿，而且使人们对终身和新出现的与衰老相关的健康问题的关注度也有所提高。以前曾研究过为智障人士提供支持的成年人的健康问题，但这些研究并不总是包括年龄较大的、居住在社区中的智障成年人。
本研究使用横断面调查，对澳大利亚东海岸两个州的大都市和农村地区的 391 名年龄在 60 岁及以上、居住在社区中的 ID 成年人的心理健康程度进行了研究。检查了一系列人口统计学（年龄、性别、居住安排、就业和社会经济地位）和生活（合并症、不良生活事件和社会支持）因素。根据两个年龄组（60-65 岁：n=234；>65 岁：n=157）对数据进行了分析。
研究结果表明，年龄较大的、居住在社区中的智障成年人与其他老年人一样，患有许多相同的心理健康障碍，但没有与老年人相关的严重精神疾病。超过三分之一（35%：n=137）报告有一个或多个心理健康障碍。年龄、性别、地点（农村或城市）、经济困难、社会支持或居住安排类型与心理健康不佳没有统计学上的显著相关性。然而，就业状况是一个明显的预测因素。逐步回归模型显示，心理健康不良与不良生活事件之间以及心理健康不良与多种身体合并症之间存在很强的关联。
本研究的横断面性质限制了因果推断。慢性病和不良生活事件的累积效应不能从过去进行预防。然而，智障成年人有很大可能经历重大和/或反复创伤，这需要更多的健康专业人员和护理人员意识到这一点，他们需要更好的医疗保健来限制身体合并症，以减轻心理健康不良的负担，这可能有助于提供更符合个人需求的支持。
