• Vol. 42 No. 7, 338–349
  • 15 July 2013

The Medical, Functional and Social Challenges Faced by Older Adults with Intellectual Disability



Introduction: Little is known about the sociodemographic and clinical profile of older adults with intellectual disabilities (ID) in Singapore. We studied the sociodemographic and clinical profile of older adults with ID and investigated factors associated with caregiver availability and identity in this population.

Materials and Methods: The study population involved all adults with ID aged ≥40 years receiving services from the Movement for the Intellectually Disabled of Singapore (MINDS), the largest such provider in Singapore. Information on sociodemographic and clinical profiles, functional status, and availability of caregivers were collected via interviewer-administered questionnaires from guardians of older adults with ID. Descriptive characteristics were computed and chi-square and logistic regression identified predictors of caregiver availability and identity.

Results: Participation was 95% (227/239). There were differences in client age, gender, and caregiver availability between recipients of residential and non-residential services (all P <0.05). Common comorbidities included hyperlipidaemia (17.6%), hypertension (15.9%), psychiatric diagnoses (16.3%) and epilepsy (10.6%). The majority were fully independent in basic activities of daily living, but only 21.1% were fully communicative. Only a small minority (9.4%) were exercising regularly. The majority (73.5%) of clients had a primary caregiver; almost equal proportions relied on either parents or siblings. Older client age was associated independently with the lack of a primary caregiver, independent of greater functional dependence and presence of medical comorbidities in the client.

Conclusion: Older adults with ID have multiple medical, functional, and social issues. More can be done to support the care of this unique group of adults with special needs.

Older adults with intellectual disabilities (ID) and their caregivers are sometimes overlooked in the planning and delivery of health services; and unfortunately, are sometimes exposed to various disparities in healthcare access and delivery. In terms of their needs, however, older adults with ID face similar challenges and priorities compared to other older adults. Top causes of mortality amongst older adults with ID include cardiovascular disease, respiratory disease, and malignancy, while cardiovascular disease
and mental disease account for significant morbidity.

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