Physical fitness is predictive for 5-year survival in older adults with intellectual disabilities

Alyt Oppewal, Thessa I M Hilgenkamp, Alyt Oppewal, Thessa I M Hilgenkamp

Abstract

Background: The very low physical fitness levels of people with intellectual disabilities (ID) may influence their life expectancy. Therefore, we investigated the predictive value of physical fitness for survival in older adults with intellectual disabilities.

Method: In the Healthy Ageing and Intellectual Disabilities (HA-ID) study,the physical fitness levels of 900 older adults (≥50 years; 61.5 ± 8.1 years) were measured at baseline. All-cause mortality was collected over a 5-year follow-up period. Cox proportional hazard models were used to determine the association between each physical fitness test and survival, adjusted for age, sex, level of ID, and Down syndrome.

Results: The physical fitness components that were independently predictive for survival were manual dexterity (HR = 0.96 [0.94-0.98]), visual reaction time (HR = 1.57 [1.28-1.94]), balance (HR = 0.97 [0.95-0.99]), comfortable gait speed (HR = 0.65 [0.54-0.78]), fast gait speed (HR = 0.81 [0.72-0.91]), grip strength (HR = 0.97 [0.94-0.99]) and cardiorespiratory fitness (HR = 0.997 [0.995-0.999]), with a better physical fitness showing a lower mortality risk.

Conclusion: We showed for the first time that physical fitness was independently associated with survival in older adults with intellectual disabilities. Improving and maintaining physical fitness must become an essential part of care and support for this population.

Keywords: activity; intellectual disabilities; mortality; older adults; physical capacity.

Conflict of interest statement

All authors declare no conflicts of interest.

© 2019 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.

References

    1. American College of Sports Medicine (2018). ACSM's guidelines for exercise testing and prescription, (10th ed.). Philadelphia, PA: Wolters Kluwer.
    1. Berg, K. O. (1989). Measuring balance in the elderly: Preliminary development of an instrument. Physiotherapy Canada, 41(6), 304–311. 10.3138/ptc.41.6.304
    1. Berg, K. O. , Wood‐Dauphinee, S. L. , Williams, J. I. , & Maki, B. (1992). Measuring balance in the elderly: Validation of an instrument. Canadian Journal of Public Health, 83(Suppl. 2), S7–11.
    1. Bernabei, R. , Martone, A. M. , Vetrano, D. L. , Calvani, R. , Landi, F. , & Marzetti, E. (2014). Frailty, physical frailty, sarcopenia: A new conceptual model. Studies in Health Technology and Informatics, 203, 78–84.
    1. Bohannon, R. W. (1997). Comfortable and maximum walking speed of adults aged 20–79 years: Reference values and determinants. Age and Ageing, 26(1), 15–19. 10.1093/ageing/26.1.15
    1. Bohannon, R. W. (2008). Hand‐grip dynamometry predicts future outcomes in aging adults. Journal of Geriatric Physical Therapy, 31(1), 3–10. 10.1519/00139143-200831010-00002
    1. Bossink, L. W. M. , van der Putten, A. A. , & Vlaskamp, C. (2017). Understanding low levels of physical activity in people with intellectual disabilities: A systematic review to identify barriers and facilitators. Research in Developmental Disabilities, 68, 95–110. 10.1016/j.ridd.2017.06.008
    1. Bouchard, C. , & Shephard, R. J. (1994). Physical activity, fitness and health: International proceedings and consensus statement. Champaign, IL: Human Kinetics Publishers.
    1. Clegg, A. , Young, J. , Iliffe, S. , Rikkert, M. O. , & Rockwood, K. (2013). Frailty in elderly people. The Lancet, 381(9868), 752–762. 10.1016/S0140-6736(12)62167-9
    1. Cooper, R. , Kuh, D. , Hardy, R. , Mortality Review Group , & FALCon and HALCyon Study Teams (2010). Objectively measured physical capability levels and mortality: Systematic review and meta‐analysis. The BMJ, 341, c4467 10.1136/bmj.c4467
    1. Coppus, A. M. (2013). People with intellectual disability: What do we know about adulthood and life expectancy? Developmental Disabilities Research Reviews, 18(1), 6–16. 10.1002/ddrr.1123
    1. Cruz‐Jentoft, A. J. , Baeyens, J. P. , Bauer, J. M. , Boirie, Y. , Cederholm, T. , Landi, F. , … Zamboni, M. (2010). Sarcopenia: European consensus on definition and diagnosis: Report of the European working group on sarcopenia in older people. Age and Ageing, 39(4), 412–423. 10.1093/ageing/afq034
    1. Dunn, J. M. (1978). Reliability of selected psychomotor measures with mentally retarded adult males. Perceptual and Motor Skills, 46(1), 295–301. 10.2466/pms.1978.46.1.295
    1. Dwyer, T. , Magnussen, C. g. , Schmidt, M. D. , Ukoumunne, O. C. , Ponsonby, A.‐L. , Raitakari, O. T. , … Venn, A. (2009). Decline in physical fitness from childhood to adulthood associated with increased obesity and insulin resistance in adults. Diabetes Care, 32(4), 683–687. 10.2337/dc08-1638
    1. Elbaz, A. , Sabia, S. , Brunner, E. , Shipley, M. , Marmot, M. , Kivimaki, M. , & Singh‐Manoux, A. (2013). Association of walking speed in late midlife with mortality: Results from the Whitehall II cohort study. Age (Dordrecht, Netherlands), 35(3), 943–952. 10.1007/s11357-012-9387-9
    1. Fess, E. E. , & Moran, C. (1981). Clinical assessment recommendations. Indianapolis, IN: American Society of Hand Therapists Monograph.
    1. Golubovic, S. , Maksimovic, J. , Golubovic, B. , & Glumbic, N. (2012). Effects of exercise on physical fitness in children with intellectual disability. Research in Developmental Disabilities, 33(2), 608–614. 10.1016/j.ridd.2011.11.003
    1. Helsinki. 2013. World Medical Association Declaration of Helsinki, Ethical Principles for Medical Research Involving Human Subjects. Retrieved from
    1. Hilgenkamp, T. I. , Bastiaanse, L. P. , Hermans, H. , Penning, C. , van Wijck, R. , & Evenhuis, H. M. (2011). Study healthy ageing and intellectual disabilities: Recruitment and design. Research in Developmental Disabilities, 32(3), 1097–1106.
    1. Hilgenkamp, T. I. , van Wijck, R. , & Evenhuis, H. M. (2010). Physical fitness in older people with ID-Concept and measuring instruments: A review. Research in Developmental Disabilities, 31(5), 1027–1038.
    1. Hilgenkamp, T. I. , van Wijck, R. , & Evenhuis, H. M. (2012a). Feasibility and reliability of physical fitness tests in older adults with intellectual disability: A pilot study. Journal of Intellectual & Developmental Disability, 37(2), 158–162. 10.3109/13668250.2012.681773
    1. Hilgenkamp, T. I. , van Wijck, R. , & Evenhuis, H. M. (2012b). Low physical fitness levels in older adults with ID: Results of the HA-ID study. Research in Developmental Disabilities, 33(4), 1048–1058.
    1. Hilgenkamp, T. I. , van Wijck, R. , & Evenhuis, H. M. (2013). Feasibility of eight physical fitness tests in 1,050 older adults with intellectual disability: results of the healthy ageing with intellectual disabilities study. Intellectual and Developmental Disabilities, 51(1), 33–47.
    1. Hui, S. S. , & Yuen, P. Y. (2000). Validity of the modified back‐saver sit‐and‐reach test: A comparison with other protocols. Medicine and Science in Sports and Exercise, 32(9), 1655–1659. 10.1097/00005768-200009000-00021
    1. Kuh, D. , Hardy, R. , Hotopf, M. , Lawlor, D. A. , Maughan, B. , Westendorp, R. , … Mishra, G. D. (2009). A review of lifetime risk factors for mortality. British Actuarial Journal, 15(S1), 17–64. 10.1017/s135732170000550x
    1. Lahtinen, U. , Rintala, P. , & Malin, A. (2007). Physical performance of individuals with intellectual disability: A 30 year follow up. Adapted Physical Activity Quarterly, 24(2), 125–143. 10.1123/apaq.24.2.125
    1. Lee, D. C. , Artero, E. G. , Sui, X. , & Blair, S. N. (2010). Mortality trends in the general population: The importance of cardiorespiratory fitness. Journal of Psychopharmacology, 24(Suppl. 4), 27–35. 10.1177/1359786810382057
    1. Malina, R. M. (2001). Physical activity and fitness: Pathways from childhood to adulthood. American Journal of Human Biology, 13(2), 162–172. 10.1002/1520-6300(200102/03)13:2<162:AID-AJHB1025>;2-T
    1. Mathiowetz, V. , Volland, G. , Kashman, N. , & Weber, K. (1985). Adult norms for the box and block test of manual dexterity. The American Journal of Occupational Therapy, 39(6), 386–391. 10.5014/ajot.39.6.386
    1. Oppewal, A. , Hilgenkamp, T. I. , van Wijck, R. , & Evenhuis, H. M. (2013). Feasibility and outcomes of the Berg Balance Scale in older adults with intellectual disabilities. Research in Developmental Disabilities, 34(9), 2743–2752.
    1. Oppewal, A. , Hilgenkamp, T. I. , van Wijck, R. , Schoufour, J. D. , & Evenhuis, H. M. (2014). Physical fitness is predictive for a decline in daily functioning in older adults with intellectual disabilities: Results of the HA-ID study. Research in Developmental Disabilities, 35(10), 2299–2315. 10.1016/j.ridd.2014.05.027
    1. Oppewal, A. , Hilgenkamp, T. I. , van Wijck, R. , Schoufour, J. D. , & Evenhuis, H. M. (2015). Physical fitness is predictive for a decline in the ability to perform instrumental activities of daily living in older adults with intellectual disabilities: Results of the HA-ID study. Research in Developmental Disabilities, 41–42, 76–85.
    1. Oppewal, A. , Schoufour, J. D. , van der Maarl, H. J. K. , Evenhuis, H. M. , Hilgenkamp, T. I. M. , & Festen, D. A. (2018). Causes of Mortality in Older People With Intellectual Disability: Results From the HA-ID Study. American Journal on Intellectual and Developmental Disabilities, 123(1), 61–71.
    1. Reppermund, S. , & Trollor, J. N. (2016). Successful ageing for people with an intellectual disability. Current Opinion in Psychiatry, 29(2), 149–154. 10.1097/YCO.0000000000000228
    1. Rikli, R. E. , & Jones, C. J. (2001). Senior fitness test manual. Champaign, IL: Human Kinetics.
    1. Rodríguez‐Mañas, L. , Féart, C. , Mann, G. , Viña, J. , Chatterji, S. , Chodzko‐Zajko, W. , … Vega, E. (2013). Searching for an operational definition of frailty: A Delphi method based consensus statement: The frailty operative definition‐consensus conference project. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 68(1), 62–67. 10.1093/gerona/gls119
    1. Salaun, L. , & Berthouze‐Aranda, S. E. (2012). Physical fitness and fatness in adolescents with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 25(3), 231–239. 10.1111/j.1468-3148.2012.00659.x
    1. Schoufour, J. D. , Mitnitski, A. , Rockwood, K. , Evenhuis, H. M. , & Echteld, M. A. (2013). Development of a frailty index for older people with intellectual disabilities: Results from the HA‐ID study. Research in Developmental Disabilities, 34(5), 1541–1555. 10.1016/j.ridd.2013.01.029
    1. Schoufour, J. D. , Mitnitski, A. , Rockwood, K. , Evenhuis, H. M. , & Echteld, M. A. (2015). Predicting 3‐year survival in older people with intellectual disabilities using a Frailty Index. Journal of the American Geriatrics Society, 63(3), 531–536. 10.1111/jgs.13239
    1. Singh, S. J. , Morgan, M. D. , Scott, S. , Walters, D. , & Hardman, A. E. (1992). Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax, 47(12), 1019–1024. 10.1136/thx.47.12.1019
    1. Strasser, B. , & Pesta, D. (2013). Resistance training for diabetes prevention and therapy: Experimental findings and molecular mechanisms. BioMed Research International, 2013, 805217 10.1155/2013/805217
    1. Studenski, S. , Perera, S. , Patel, K. , Rosano, C. , Faulkner, K. , Inzitari, M. , … Guralnik, J. (2011). Gait speed and survival in older adults. Journal of the American Medical Association, 305(1), 50–58. 10.1001/jama.2010.1923
    1. Swets, J. A. (1988). Measuring the accuracy of diagnostic systems. Science, 240(4857), 1285–1293.
    1. U.S. Department of Health and Human Services (2008). Physical activity guidelines advisory committee report . Retrieved from Washington, DC.
    1. Willems, M. , Hilgenkamp, T. I. , Havik, E. , Waninge, A. , & Melville, C. A. (2017). Use of behaviour change techniques in lifestyle change interventions for people with intellectual disabilities: A systematic review. Research in Developmental Disabilities, 60, 256–268. 10.1016/j.ridd.2016.10.008
    1. Yang, Q. , Cogswell, M. E. , Flanders, W. D. , Hong, Y. , Zhang, Z. , Loustalot, F. , … Hu, F. B. (2012). Trends in cardiovascular health metrics and associations with all‐cause and CVD mortality among US adults. Journal of the American Medical Association, 307(12), 1273–1283. 10.1001/jama.2012.339

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