The association of life events and mental ill health in older adults with intellectual disability: results of the wave 3 Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing

Abstract

Background Exposures to life events are associated with emotional, psychological and behavioural problems in those with intellectual disability (ID). Older adults with ID may experience different life events given differences in living circumstances, cognitive decline, greater dependency on others and less autonomy. This study examines the relationship of life events and mental ill health in an older ID population in Ireland. Methods The study was part of ‘The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing’. The frequency of life events was assessed using a 20‐item checklist, and the level of stress experienced was assessed using a three‐point Likert scale measuring the burden of the life event. The associations of life events with factors associated with mental ill health were measured using a variety of self‐report and proxy completed questionnaires. Results For the study population, 88.1% had been exposed to at least one life event in the preceding 12 months and 64.5% to two or more life events. Frequency and burden of life events were significantly higher in individuals living in institutional settings and in individuals with any current psychiatric condition, increased depressive and anxiety symptoms, challenging behaviour and reported poorer self‐rated mental and physical health. More life events were significantly associated with new psychiatric diagnoses as well as initiation and increased dosage of mood stabilising, hypnotic and sedative medications. Conclusions Life events are significantly associated with mental ill health in the older ID population. Service providers must focus on limiting the exposure to these events and, in situations where they cannot be avoided, should support and manage individuals compassionately and effectively, prioritising their mental and physical well‐being.

Biopsychosocial factors associated with depression and anxiety in older adults with intellectual disability: results of the wave 3 Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing

“…Interviews were a mix of self‐report and proxy interviews completed by family and/or staff members and were administered by a trained interviewer in a location of the participant's choice, usually their home or day service centre (Bond et al . 2019).…”

“…It was not possible to definitively conclude that anti‐epileptic medication was indicated for mood stabilisation as opposed to seizure control in participants with a diagnosis of epilepsy (Bond et al . 2019). We therefore excluded these participants ( n = 31) from the analyses. Anxiolytics (N05B) excluding rectal diazepam and Clobazam as they are used primarily for epilepsy as opposed to anxiety disorders Sedatives and hypnotics (N05C) excluding midazolam as its primary use is for acute seizure control as oppose to mental health conditions…”

“…2013) and life events such as the death of a relative or friend, a change in the frequency of visits from family or friends and a change in the staff in the home or day service (Bond et al . 2019). Further research into physical and psychosocial factors that may cause or exacerbate depression and anxiety in older adults with ID is important for the development of prevention and treatment guidelines.…”

Specialist psychiatric health care utilization among older people with intellectual disability – predictors and comparisons with the general population: a national register study

“…Albeit of these divergent figures, psychiatric disorders are more prevalent among adults with ID than in the adult general population [8,9]. An increased life expectancy among people with ID [10,11], together with a positive association between age and psychiatric disorders in this group [1,[12][13][14], results in an increasing number of older people with ID and concurrent psychiatric disorders. Research regarding psychiatric health care utilization among older people with ID is scarce [15], however, and the present study addresses this knowledge gap.…”

Optimising psychotropic medication prescribing to reduce adverse drug events

“…Bond et al . () report on the association between life events and mental ill health in older adults with intellectual disability, using longitudinal data from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS‐TILDA). They found that experiencing more life events was significantly associated with the development of new psychiatric problems, as well as the initiation and increased dosage of psychotropic medications, suggesting that interventions to reduce an excess of life events in older adults with ID (e.g.…”