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Frailty Index Specific to Older Adults With Intellectual/Developmental Disabilities

November 08, 2016

Researchers recently developed a frailty index (FI) specific to older adults with intellectual and developmental disabilities (IDD) that could be incorporated into existing home care assessments.

The aging population of adults with IDD is growing, but existing frailty measures are less appropriate for aging persons with IDD, given their pre-existing conditions and limitations. Frailty measures specific to persons with IDD have not been widely studied.

Katherine McKenzie, MSc, (Queens University, Canada) and colleagues used pre-determined criteria to develop an FI specific to those with IDD based on items in the Resident Assessment Instrument - Home Care (RAI-HC), and using the assessments of 7,863 individuals with IDD in Ontario (aged 18–99 years) admitted to home care between April 1st, 2006 and March 31st, 2014.

FI scores were derived by dividing deficits present by deficits measured, and categorized into meaningful strata using stratum-specific likelihood ratios. A multinomial logistic regression model identified associations between frailty and individual characteristics.

The resulting FI was comprised of 42 deficits across five domains (physiological, psychological, cognitive, social, and service use). The mean FI score was 0.22 (SD = 0.13), equivalent to 9 deficits. Over half of the cohort was non-frail (FI score < 0.21), while the remaining were either pre-frail (21 %, FI score between 0.21 and 0.30) or frail (27 %, FI score > 0.30).

Controlling for individual characteristics, women were more likely to be frail compared to men (OR = 1.39, 95 % CI: 1.23–1.56). Individuals who were frail were significantly more likely to have a caregiver who was unable to continuing caring (OR = 1.86, 95 % CI: 1.55–2.22) or feeling distressed (OR = 1.54, 95 % CI: 1.30–1.83). 

Authors concluded that the FI was feasible to use to identify frailty in adults with IDD and could be incorporated into existing home care assessments. The FI could offer “case managers assistance in identifying at-risk individuals.” Future studies, they said, need to determine the ability of the FI to predict future outcomes.—Amanda Del Signore

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