Physical mobility and aging in intellectual disability
Cleaver, Shaun Robert
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Background: The growing population of older adults with intellectual disabilities is likely to experience secondary disabilities that affect well-being. Despite the established importance of mobility in the general population, there is little evidence of a scientific base on mobility limitations for people with intellectual disabilities. Objectives: The aim of this study was to better understand mobility limitations in adults with intellectual disabilities, age 45 and over, by describing the prevalence and severity of mobility limitations and determining the association with living in a high support setting. Methods: A systematic review of published literature on mobility limitations among adults with intellectual disabilities was conducted using a pre-determined search and extraction strategies. A cross-sectional study was then conducted among a representative sample of adults, age 45 and over with intellectual disabilities in South Eastern Ontario. Data was collected through standardized proxy response telephone surveys and analyzed descriptively to determine the prevalence and severity of mobility limitations in this population. A multivariate logistic regression model was then used to examine the association between mobility limitations and residential status. Results: The systematic review identified 32 publications that met all inclusion criteria. Publications were generally not focused on mobility, cross-sectional in design and few investigators addressed key methodological features in their report. Original data was collected for 128 older adults with intellectual disabilities. The prevalence of mobility limitations varied according to the definition employed. Using comparable definitions, this prevalence was higher than what is seen in the general Canadian population. The prevalence of mobility limitations was not found to increase with age but was greater in females than males. People with intellectual disabilities and mobility limitations had 3.6 times greater odds of living in high support residential settings than those without mobility limitations. This difference was statistically significant. Conclusion: Past epidemiological research on mobility limitations for people with intellectual disabilities is of poor quality. In addressing these limitations, this study found that mobility limitations are common among people with intellectual disabilities and are associated with meaningful outcomes, such as the place in which a person lives.