Erasmus MC Press Release Rotterdam, 21 December 2011
Intellectually disabled to exercise more for better health
Erasmus MC studied health improvement of intellectually disabled with increasing life expectancy
People over the age of 50 with an intellectual disability appear to be ‘older’ that their peers in the general population. Their vulnerability can be compared to that of healthy people who are roughly 15 years older. In order to reduce this vulnerability, more attention needs to be paid to a healthy lifestyle.  The fitness of the people in this group can and must be improved so as to prevent chronic health problems. This is the conclusion of the GOUD study (GOLD study - Healthy ageing and intellectual disability), carried out by Erasmus MC in collaboration with three major Dutch care providers. The GOUD study will be discussed extensively in the coming edition of Monitor, Erasmus MC’s magazine.
For the GOUD study, Erasmus MC collaborated with three care providers for people with an intellectual disability: Ipse de Bruggen (Zwammerdam), Abrona (Huis ter Heide) and Amarant (Tilburg).  The care providers perceive that the average life expectancy of their residents is increasing and they would like to link this to improved health and longer life. This is important for the good of the people themselves as well as for the level of care needed and the costs of the care.  

Together with Prof. Heleen Evenhuis, professor of Medicine for intellectually disabled at the General Practice department of Erasmus MC, the potential improvements were examined. A total of 1050 clients over the age of 50 took part in the study. They underwent physical examinations, a fitness test, were given pedometers and biological rhythm meters and screened for depression and anxiety. The majority of the clients appeared to have a very low level of physical activity and fitness which can result in obesity, depression and increased risk of cardiovascular diseases, loss of muscle mass and strength and consequently reduced mobility. In addition, chronic health problems accumulate.  

Evenhuis: “The analyses show that vulnerability among people with an intellectual disability is already as common in the age group 50 – 64 year olds as it is in the general population aged over 65. Over the age of 65 it continues to increase substantially. This possibly explains the concept of ‘ageing more rapidly’.”  A relatively early decline in interests, mobility and independence are common. Half of the intellectually disabled aged over 50 live in accommodation where care is provided at a level comparable to that of care homes or nursing homes, compared to only 6% of the general population aged over 65. 

Evenhuis: “This vulnerability can be reduced by encouraging physical activity. However, this involves a change in lifestyle by a group who cannot, or only to a certain extent, take responsibility for this.” The GOUD consortium has already completed an exercise program at the day care (3 times a week for 8 months), combined with  an educational program twice a week that has led to specific examples of how these people become physically active. Evenhuis: “Although the effect analyses have only just started, it has become clear that the activities are greatly appreciated by most of the participants. It also appears that the activity instructors need continual professional coaching for the intervention to be effective.” The educational as well as the exercise program are being adapted for widespread distribution together with Vilans.   

Monitor will be available online as of  23 December at
Erasmus MC is the largest University Medical Center in the Netherlands. Our primary goal is a healthy population. Nearly 13,000 employees devote themselves every day to providing outstanding care, facilitating world-class education and conducting pioneering research. These professionals are instrumental in developing expertise on health and illness. They link the latest scientific insights to practical treatments and prevention measures to provide maximum benefit to patients and to enable healthy people to stay healthy longer. Being visibly better and leading the way in the areas of complex, innovative and acute care by collaborating with others: these are key ambitions at Erasmus MC.