The results suggest that older adults who start drinking heavily (very) late in life have similar cognitive impairments compared to their peers who have been drinking for decades. This emphasizes the vulnerability of the aging brain to the toxic effects of alcohol.

Background People with intellectual disabilities have increasing difficulties managing their daily affairs. This study examined the effectiveness of a staff training, which teaches staff to promote self‐management in people with intellectual disabilities. Method Effectiveness was assessed with questionnaires addressing clients’ (n = 26) independence and self‐reliance, support needs and challenging behaviour, using a pre–posttest control group design. Additionally, focus groups were conducted with trained staff members 6 months after the training. Results In the long term, the intervention group showed a significant increase in independence and self‐reliance, in contrast to the comparison group. No effect was found on support needs and challenging behaviour. Trained staff members reported limited benefits of the training, but had noticed changes in their attitude and method of working afterwards. Conclusions Further self‐management research is required to investigate how independence and self‐reliance can be promoted more effectively in this population. Future trainings should carefully consider their content, format, and implementation.

People with intellectual disabilities (ID) commonly struggle with managing their affairs, while they consider it important to be independent. This study aimed to gain insight into the perspectives of people with ID, legal representatives, and support staff on promoting independence in this population. Two focus groups were conducted with people with ID (n = 7), two with legal representatives (n = 13), and three with support staff (n = 17). Topics included the meaning of independence, the current level and needs of people with ID regarding their independence, and what they perceived as barriers and requirements when wanting to promote independence in this group. Possible outcomes of a greater independence of people with ID were also discussed. Verbatim transcripts were analyzed qualitatively with a general inductive approach. According to the respondents, people with ID require support from others, but most want to be more independent. Various barriers are experienced when trying to promote independence. These concern barriers at the level of support staff (e.g., lack of time), family (e.g., taking over tasks), and of the persons with ID themselves (e.g., emotional difficulties). When promoting independence in this population, more support and time seem necessary, as well as a clear, step‐by‐step tailored approach and good communication between all parties involved. Last, several advantages (e.g., greater self‐worth) and risks (e.g., overestimation by others, greater exposure to hazards) were proposed that could result from a greater independence of people with ID. As this study showed that people with ID generally want to become more independent. This stresses the need for the development of interventions, which could benefit from the findings from this study.

Background To help people with intellectual disabilities lead a more independent life, it is important to promote their self‐management. This study evaluated the effectiveness of a self‐management training for people with intellectual disabilities directed at independent functioning in daily life. Method In the training, 17 people with intellectual disabilities worked on personal self‐management goals covering a wide range of everyday affairs. Primary outcome measures focused on goal attainment, independence and support needs. Moreover, outcomes regarding psychopathological behaviour and quality of life were explored. Data were collected before and at the start of the training, and 3, 6, 9 and 12 months later. Results The training contributed to the attainment of self‐management goals and to the reduction in support needs (p < 0.01). There were no changes in independence, psychopathological behaviour and quality of life. Conclusions Results indicate that the training supports people with intellectual disabilities to self‐manage their daily affairs.

People with intellectual disabilities (ID) often experience difficulties managing their affairs. This study reviewed self-management interventions for people with mild to moderate ID, studying interventions' effectiveness and applied behavioural change techniques (BCTs). Methods: A systematic literature search was conducted in PubMed, PsychINFO, Web of Science, Embase, Emcare, Cochrane, and ProQuest. Data were extracted on study, intervention, and participant characteristics, and results. Results: Of the 681 studies retrieved, 36 met the inclusion criteria. Most studies used case study designs and small samples. There were eight randomised controlled trials and one non-randomised study. Studies were mostly of moderate quality (Mixed Methods Appraisal Tool). Twenty-two interventions targeted a singular practical skill for a specific context. In allinterventions, the provider applied several BCTs; in 13 studies participants were also trained to apply BCTs themselves. In all studies, improvements in self-management were reported, which mostly maintained over time (n = 20). If measured, generalisation to other settings was also found. Conclusions: Future studies should aim for a higher methodological quality and couldconsider targeting more generic self-management and a wider application of BCTs by people with ID themselves. Practice implications: The findings suggest that training can promote self-management in people with ID.

Background Support staff of adults with intellectual disability (ID) play an important role in promoting independence in home and community settings. However, little is known about the types of behaviours staff should use to promote independence and instruments that assess such behaviour do not yet exist. The aim of this study was therefore to develop and initially validate a reliable questionnaire that measures the degree to which support staff display behaviours that promote independence in people with ID. Method The Leiden Independence Questionnaire for Support Staff (LIQSS) was constructed to measure the extent to which support staff promote independence in people with ID. The LIQSS was completed by 142 staff members working with people with ID. For the psychometric evaluation of the LIQSS, a principal component analysis was performed with an oblique rotation in all items. Next, the principal component analysis was performed with a forced three-component extraction, and three subscales were computed. To assess internal consistency, Cronbach's α was calculated for each of the subscales.Results The LIQSS was found to consist of three internally consistent (Cronbach's α was respectively 0.92, 0.79 and 0.76) and meaningful components: (1) communication, agreements and coordination; (2) positive encouragement and tailoring; and (3) supporting independent performance. The final 22 items had factor loadings between 0.44 and 0.91 on their corresponding component and a minimal difference in loading to the other factors of 0.20.Conclusions The LIQSS appears to be an instrument with positive face validity and reliability (internal consistency) that assesses the degree to which support staff promote independence in people with ID. To increase the instrument's value for both scientific research and clinical practice, studies should focus on the further validation of the LIQSS.

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