Department of Psychiatry and Behavioral Sciences (EW), Johns Hopkins University School of Medicine, Baltimore, MD.
Department Neuropsychology (CH), Kennedy Krieger Institute, Baltimore, MD; Department of Mental Health (CH), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Am J Geriatr Psychiatry. 2022 Jan;30(1):65-77. doi: 10.1016/j.jagp.2021.05.022. Epub 2021 Jun 4.
Adults with intellectual and developmental disabilities (IDD) are living longer, yet research about the medical and psychiatric needs of older adults still lags behind that of younger individuals with IDD. The aim of this study was to assess age-related differences in the mental health presentations of adults with IDD.
Fully deidentified data for adults 30 years and older were extracted from the START (Systemic, Therapeutic, Assessment, Resources, and Treatment) Information Reporting System, a deidentified database housed at the Center for START Services. Caregivers and START team documents reported psychiatric diagnoses, service use, recent stressors, and challenging behaviors. t Tests, Mann Whitney U tests, χ tests, and multinominal logistic regression models were used to compare the two age groups, 30-49 years (n = 1,188) versus 50 years and older (n = 464).
Older adults had more medical conditions, fewer reported psychiatric conditions, and were more likely to be taking more psychiatric medications compared to younger adults, after adjusting for demographic variables, disability level, and number of recent stressors.
Although older individuals reported fewer psychiatric diagnoses, they were more likely to take higher numbers of psychiatric medications and have more medical conditions. Clinicians and researchers ought to devote more attention to the healthcare needs of older adults with IDD, a vulnerable group exposed to polypharmacy and at risk of adverse events.
患有智力和发育障碍（IDD）的成年人寿命更长，但有关老年人的医疗和精神需求的研究仍然落后于年轻的 IDD 患者。本研究旨在评估成年人 IDD 患者心理健康表现的年龄相关差异。
从 START（系统、治疗、评估、资源和治疗）信息报告系统中提取了年龄在 30 岁及以上的成年人的完全去识别数据，该系统是一个位于 START 服务中心的去识别数据库。护理人员和 START 团队文档报告了精神科诊断、服务使用、近期压力源和挑战性行为。t 检验、Mann Whitney U 检验、卡方检验和多项逻辑回归模型用于比较两个年龄组，30-49 岁（n=1188）与 50 岁及以上（n=464）。
在调整了人口统计学变量、残疾程度和近期压力源数量后，与年轻成年人相比，老年成年人的身体状况更多，报告的精神状况更少，服用的精神药物也更多。
尽管年龄较大的成年人报告的精神科诊断较少，但他们更有可能服用更多种类的精神科药物，并且患有更多的身体疾病。临床医生和研究人员应该更加关注患有 IDD 的老年成年人的医疗保健需求，因为他们是一个容易出现药物滥用和不良事件风险的脆弱群体。
