Context
Today, people with intellectual disabilities live longer thanks to the improved support that has been offered. Up until now, knowledge about the health and support needs of this new target group (the elderly who have intellectual disabilities) has been inadequate. ZonMw promotes the collaboration and the acquisition of knowledge by means of providing a large funding round aimed at researching the health of people with intellectual disabilities. Academic Collaboration Centers assume a prominent role in this endeavor.
Goals
Three research topics in the field of healthy aging were investigated: Physical Activity & Fitness, Nutrition & Nutritional Status, and Depression & Anxiety.
The following subjects were researched:
- Identifying prevalences, high-risk groups, and health effects within each research topic and identifying the interconnections between the topics.
- Examining the acceptance, implementation, and health effects of a day-activity program aimed at promoting exercise and physical fitness.
- Understanding the distribution and severity when applying measures used to gauge public health such as: vulnerability, healthy and unhealthy life years, multimorbidity and polypharmacy, and factors that have a conducive and protective influence.
Results
In this first phase, the HA-ID studies were co-funded from ZonMw’s People with Intellectual Disabilities Program (Project no. 57000003) and the National Care for the Elderly Program (Project no. 314030302).
1.1 Epidemiological research on three themes
The health of a group of 1,050 people aged over 50 was examined in the widest sense. This study revealed group-specific health issues. Lifestyle, vulnerability, cardiovascular health, and mental health were not only problems that were encountered with increasing frequency, and at a younger age, but the group also had group-specific causes: reduced muscle mass, unbalanced circadian rhythm, an increased use in the medication taken, and a higher frequency of life events. See the full results presented in the HA-ID report here.
1.2 Follow-up study on vulnerability
The multidimensionality of many problems led to follow-up research on vulnerability in this target group. The degree of vulnerability of those over 50 years old was found to be similar to that of those aged over 75 in the general population, whereas the prevalence of chronic multimorbidity was similar to that of the Dutch population living in nursing homes. However, some of the health problems were different from those of the vulnerable or frail elderly in the general population. Because many of the factors that threaten health are present in the group aged between 50-59, younger age groups will be needed in the follow-up research on healthy aging. In addition to self-reliance, the care burden (and thus the healthcare costs) has been determined to a great extent by vulnerability, multimorbidity, and polypharmacy. See the articles under publications -> ‘subproject: vulnerability’.
1.3 Exercise more in daycare setting
The effects of an educational and exercise program for the elderly which aims at improving their health and physical fitness were studied. The study showed that the elderly can indeed improve their physical fitness and health by participating in a fun and feasible program. You can read more about this here. See the articles under publications -> ‘subproject: Exercise program HA-ID 1.
Follow-up steps
Individual report
Each participant and their family members received an individual report which showed the results of the health measures that had been taken. We recommended or initiated follow-up steps to improve the participants’ health. Dozens of medical, paramedical and behavioral health professionals enriched their expertise by employing new work methods and measurement tools and by taking part in the measurements and training sessions.
Nationwide system change
As a result of HA-ID 1, a nationwide system was implemented in which the support that had been offered by the AWBZ (Exceptional Medical Expenses Act) was primarily transferred to the Wmo (Social Support Act). This had far-reaching consequences for the field of healthcare. There was a need to substantiate the decision making regarding the type of support each group needed. The HA-ID results were used as means to justify the specialized support needed by those who had previously received a ZZP Indication (Care Intensity Package Indication) of 3 or 4, after the system change had been implemented as well. See the full report on ZZP Indication 3 via the link and here for ZZP Indication 4.
Exercise program
The HA-ID exercise program was developed into a fully downloadable program with support material in collaboration with Vilans and Kennisplein Gehandicaptensector (Knowledge Meeting Place for the Disability Sector). It has been made available free of charge at www.kennispleingehandicaptensector.nl/bewegen. Furthermore, dozens of international academic publications have been based on this research.