PTOTCohortJournal of applied research in intellectual disabilities : JARID2019

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

Alyt Oppewal, Thessa I M Hilgenkamp

PMID 30950160

WHAT IT FOUND

Better fitness predicted lower 5-year mortality risk in older adults with intellectual disabilities.

Manual dexterity, visual reaction time, balance, walking speed, grip strength and cardiorespiratory fitness were associated with survival.

Key findings

01After adjustment for age, sex, level of intellectual disabilities and Down syndrome, manual dexterity, visual reaction time, balance, comfortable gait speed, fast gait speed, grip strength and cardiorespiratory fitness predicted survival; auditive reaction time, muscular endurance and flexibility did not.

02Comfortable gait speed was associated with a 35% lower mortality risk per km/h.

03Manual dexterity, comfortable gait speed, fast gait speed and cardiorespiratory fitness had moderate accuracy in separating survivors from deceased participants, with accuracy scores of 0.71, 0.72, 0.70 and 0.70.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Adults without registered care or support were not included, and adults who only attend day care or receive ambulatory care were underrepresented. Adults with severe or profound intellectual disabilities and wheelchair users were underrepresented in the physical fitness assessments. 56 participants were lost to follow-up; they were younger and had better manual dexterity, comfortable walking speed and cardiorespiratory fitness, so loss may have biased results. Physical fitness was measured only once, so changes in fitness over time were not assessed. The study looked only at all-cause mortality, not cause-specific mortality. The sample had very low baseline fitness, which may limit how well the tests discriminate between survivors and participants who died.

Declared interests

The authors declared no conflicts of interest. The study was funded by the Netherlands Organization for Health Research and Development (ZonMw).

The easy way to misread this

Do not conclude that improving fitness will increase survival. The study observed associations between baseline fitness and mortality; it did not test a training intervention.

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