Editorial
An age-old problem?
Journal of Intellectual Disabilities 2015, Vol. 19(2) 101–102 ª The Author(s) 2015 Reprints and permission: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1744629515578347 jid.sagepub.com
Precise figures concerning the number of people who have intellectual disabilities are difficult to obtain due to (for example) differences in diagnostic criteria, service eligibility criteria and methods of recording. However, despite these difficulties and differences, one overall trend is evident, that is, people with intellectual disabilities are living longer. Whilst recent research indicates that they still tend to die younger than their non-disabled peers (Heslop et al., 2013), their life expectancy is greater than it used to be and this presents challenges for both practice and research. Ill health is not an inevitable consequence of ageing and many public health campaigns encourage populations to pursue ‘healthy ageing’, which involves engaging in regular exercise, eating a healthy diet and keeping mentally active through social interaction and other activities that stimulate our cognitive processes. However, research has already shown us that people with intellectual disabilities are less likely to engage in exercise, are more likely to have an unhealthy diet and be obese, and their social interactions can often be more limited. Not only, therefore, is there a danger that they will be excluded from the wider focus on healthy ageing but this is also likely to be compounded by a legacy of lifetime health inequalities. There is also a danger of diagnostic overshadowing occurring on two fronts, as emerging health problems are viewed either as a manifestation of their intellectual disabilities or as an inevitable consequence of ageing. Both (incorrect) assumptions could lead to potentially treatable conditions being missed and preventative action from being taken. How we can work with people with intellectual disabilities throughout their lifetime to promote healthy ageing and the impact this has on health in older age are, therefore, important areas for us to address. Nonetheless even where individuals do take action to promote healthy ageing we know that ageing brings with it an increased risk of experiencing certain health problems, particularly longterm or chronic illnesses. Furthermore, these health problems often do not occur in isolation and it is not uncommon for people to experience multiple long-term health problems that impact upon each other both in terms of their effects on quality of life and in terms of their treatment. That is, interventions to address one problem can often lead to the development of other conditions/illnesses. The management of such multiple long-term/chronic health problems can therefore be complex and their impact on individuals significant.
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102
Journal of Intellectual Disabilities 19(2)
Recent years have seen the development of some programmes of research focused on ageing and people with intellectual disabilities and our knowledge in this area is expanding. However, gaps remain. For example, Flynn et al.’s article in this volume highlights that whilst we have increased information regarding the prevalence of chronic health problems among people with intellectual disabilities, we know little regarding the psychological impact of such conditions on individuals. This is a significant gap, given the impact that such health problems can have on overall quality of life. Researching long-term age-related health conditions among people with intellectual disabilities is not without its difficulties. People with intellectual disabilities are a minority group within the population and therefore those who are ageing with long-term health problems represent a minority within a minority; whilst numbers are increasing, they remain relatively small. This can prove challenging in terms of identifying and accessing an adequate sample particularly as we know that many people with intellectual disabilities have unrecognized and therefore untreated conditions. Such problems are not insurmountable and using data from (for example) annual health checks and developing multicentre studies can potentially address them. In terms of service provision, research has also explored different ways of supporting people with intellectual disabilities as they age. However, once again there are areas that still require further examination such as (for example) how do we best prepare those who provide support to understand and meet changing needs that arise as a consequence of the ageing process. That people with intellectual disabilities are living longer suggest that support in relation to their health needs has improved over recent years. However, the fact that they still die younger than their non-disabled peers indicates that further work in this area is required. Also whilst the quantity of life is important, it is also essential that quality of life is given equal attention yet the psychological impact of ageing and ill health is under-researched. It is therefore important that not only do we continue to develop research concerning people with intellectual disabilities and their physical and psychological health as they age but also that we use the findings of such research to inform service development for an important and growing section of the population we support. Ruth Northway, Editor-in-chief University of South Wales, UK Reference Heslop P, Blair P, Fleming P, et al. (2013) Confidential Inquiry into Premature Deaths of People with Learning Disabilities. Bristol: Norah Fry Research Centre.
Downloaded from jid.sagepub.com by guest on November 15, 2015
An age-old problem?
Journal of Intellectual Disabilities 2015, Vol. 19(2) 101–102 ª The Author(s) 2015 Reprints and permission: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1744629515578347 jid.sagepub.com
Precise figures concerning the number of people who have intellectual disabilities are difficult to obtain due to (for example) differences in diagnostic criteria, service eligibility criteria and methods of recording. However, despite these difficulties and differences, one overall trend is evident, that is, people with intellectual disabilities are living longer. Whilst recent research indicates that they still tend to die younger than their non-disabled peers (Heslop et al., 2013), their life expectancy is greater than it used to be and this presents challenges for both practice and research. Ill health is not an inevitable consequence of ageing and many public health campaigns encourage populations to pursue ‘healthy ageing’, which involves engaging in regular exercise, eating a healthy diet and keeping mentally active through social interaction and other activities that stimulate our cognitive processes. However, research has already shown us that people with intellectual disabilities are less likely to engage in exercise, are more likely to have an unhealthy diet and be obese, and their social interactions can often be more limited. Not only, therefore, is there a danger that they will be excluded from the wider focus on healthy ageing but this is also likely to be compounded by a legacy of lifetime health inequalities. There is also a danger of diagnostic overshadowing occurring on two fronts, as emerging health problems are viewed either as a manifestation of their intellectual disabilities or as an inevitable consequence of ageing. Both (incorrect) assumptions could lead to potentially treatable conditions being missed and preventative action from being taken. How we can work with people with intellectual disabilities throughout their lifetime to promote healthy ageing and the impact this has on health in older age are, therefore, important areas for us to address. Nonetheless even where individuals do take action to promote healthy ageing we know that ageing brings with it an increased risk of experiencing certain health problems, particularly longterm or chronic illnesses. Furthermore, these health problems often do not occur in isolation and it is not uncommon for people to experience multiple long-term health problems that impact upon each other both in terms of their effects on quality of life and in terms of their treatment. That is, interventions to address one problem can often lead to the development of other conditions/illnesses. The management of such multiple long-term/chronic health problems can therefore be complex and their impact on individuals significant.
Downloaded from jid.sagepub.com by guest on November 15, 2015
102
Journal of Intellectual Disabilities 19(2)
Recent years have seen the development of some programmes of research focused on ageing and people with intellectual disabilities and our knowledge in this area is expanding. However, gaps remain. For example, Flynn et al.’s article in this volume highlights that whilst we have increased information regarding the prevalence of chronic health problems among people with intellectual disabilities, we know little regarding the psychological impact of such conditions on individuals. This is a significant gap, given the impact that such health problems can have on overall quality of life. Researching long-term age-related health conditions among people with intellectual disabilities is not without its difficulties. People with intellectual disabilities are a minority group within the population and therefore those who are ageing with long-term health problems represent a minority within a minority; whilst numbers are increasing, they remain relatively small. This can prove challenging in terms of identifying and accessing an adequate sample particularly as we know that many people with intellectual disabilities have unrecognized and therefore untreated conditions. Such problems are not insurmountable and using data from (for example) annual health checks and developing multicentre studies can potentially address them. In terms of service provision, research has also explored different ways of supporting people with intellectual disabilities as they age. However, once again there are areas that still require further examination such as (for example) how do we best prepare those who provide support to understand and meet changing needs that arise as a consequence of the ageing process. That people with intellectual disabilities are living longer suggest that support in relation to their health needs has improved over recent years. However, the fact that they still die younger than their non-disabled peers indicates that further work in this area is required. Also whilst the quantity of life is important, it is also essential that quality of life is given equal attention yet the psychological impact of ageing and ill health is under-researched. It is therefore important that not only do we continue to develop research concerning people with intellectual disabilities and their physical and psychological health as they age but also that we use the findings of such research to inform service development for an important and growing section of the population we support. Ruth Northway, Editor-in-chief University of South Wales, UK Reference Heslop P, Blair P, Fleming P, et al. (2013) Confidential Inquiry into Premature Deaths of People with Learning Disabilities. Bristol: Norah Fry Research Centre.
Downloaded from jid.sagepub.com by guest on November 15, 2015
