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Tijdschrift voor Gerontologie en Geriatrie

, Volume 46, Issue 2, pp 92–103 | Cite as

Kwetsbaarheid bij ouderen met een verstandelijke beperking: operationalisering, risico en opsporing

  • Josje D. SchoufourEmail author
  • Michael A. Echteld
  • Heleen M. Evenhuis
Article

Samenvatting

Ondanks een toename in levensverwachting, is er in de oudere populatie met verstandelijke beperkingen nogal eens sprake van multipele gezondheidsproblemen en vroegtijdige functionele achteruitgang. Wij maakten gebruik van de data van de studie Gezond Ouder met een verstandelijke beperking (GOUD), om in deze populatie de kwetsbaarheid in kaart te brengen, geoperationaliseerd als een speciaal ontwikkelde kwetsbaarheidsindex van 50 items. Omdat nog niet eerder een kwetsbaarheidsindex was toegepast in een vroeg-gehandicapte populatie, moest vastgesteld worden of deze even voorspellend is voor achteruitgang van gezondheid en zelfstandigheid als in de algemene oudere populatie. In dit artikel geven wij een samenvatting van de opzet en resultaten. In een bijna-representatieve studiepopulatie van 982 50-plus cliënten van de verstandelijk gehandicaptenzorg bestudeerden wij cross-sectioneel de verdeling van kwetsbaarheid, en gedurende een follow-up van 3 jaar de predictieve validiteit. De resultaten tonen dat deze populatie gemiddeld eerder en ernstiger kwetsbaar is dan de algemene 50-plus populatie. Een hogere mate van kwetsbaarheid is voorspellend voor achteruitgang van (instrumentele) ADL en mobiliteit, toename van het medicijngebruik, hogere zorgbehoefte, en hogere sterfte, maar niet voor toename in ziekenhuisopnames. In een hypothetisch model van potentiële oorzaken van kwetsbaarheid maken wij duidelijk, waarop preventie en interventie zich moeten richten, om te komen tot meer gezonde, zelfstandige en kwalitatief bevredigende levensjaren voor deze groep.

Trefwoorden

Kwetsbaarheid Ouderen Verstandelijke handicap Overlijden Achteruitgang in gezondheid 

Frailty in people with intellectual disabilities: operationalization, risks and detection

Abstract

Although the population with intellectual disabilities (ID) is increasingly growing older, there seems to be an early onset of functional decline in this group, which could be explained by frailty. We used data from the Healthy Aging and Intellectual Disability study (HA-ID) to measure frailty in people with ID. Frailty was measured with an adapted version of the frailty index, consisting of 50 health and age related deficits. We were the first to measure frailty with a frailty index in this population, and therefore its validity, in terms of predictive value, needed to be established. In the current article we provide an overview of the design of the frailty index and its relation with adverse health outcomes. In a nearly representative study population of 982 50-plus older adults with ID, we studied the prevalence of frailty and its validity over a 3-year follow-up period. Results show that people with ID were earlier and more severely frail than people from the general population. Frailty was related to early mortality, to disabilities in daily functioning and mobility, to increased medication use, and increased care intensity, but not to hospitalization. Using a hypothetical model, we identify possible interventions to increase the healthy life years in people with ID.

Keywords

Frailty Elderly people Intellectual disability Mortality Deterioration of health 

Notes

Dankwoord

ZonMw verstrekte een subsidie voor dit onderzoek in het kader van het Nationaal Programma Ouderenonderzoek. Graag danken wij de bestuurders, de stuurgroep en de interne coördinatoren van het GOUD-consortium: Ipse de Bruggen te Zoetermeer, Abrona te Huis ter Heide, en Amarant te Tilburg. Tevens danken wij alle deelnemers en hun familie, en alle medewerkers in de zorg, die een bijdrage hebben geleverd aan de metingen.

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Copyright information

© The Society Stichting Vilans 2015

Authors and Affiliations

  • Josje D. Schoufour
    • 1
    Email author
  • Michael A. Echteld
    • 1
  • Heleen M. Evenhuis
    • 1
  1. 1.Geneeskunde voor verstandelijk gehandicapten, HuisartsgeneeskundeErasmus medisch centrumRotterdamNederland

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