Psychiatry of Intellectual Disability in the Elderly: A Baseline Audit

Intellectual disabilities (ID) are lifelong conditions characterized by deficits in general intellectual functioning and adaptive skills with onset in the developmental period. Globally, the prevalence of ID varies by age and the prevalence in older adults is considerably lower than that in the general population indicating that people with ID (PWID) may have shorter life spans. Despite the substantially increased mean life expectancy compared to the past, PWID continue to experience poor care often dying twenty years earlier than others. Higher rates of mental illnesses, increased risk of physical health morbidity and mortality and advancing age worsen their health disadvantage. There is very limited evidence that the treatment needs of the elderly patient group with ID and a mental illness have either been described or addressed. We aimed to conduct a baseline audit and service evaluation describing the sociodemographic, clinical and treatment variables of elderly patients (aged over 65 years) attending a specialist out-patient psychiatry clinic for PWID, compliance with the suggested audit standards for this group, and make recommendations for future clinical practice. Results are presented in tabular form, with extensive psychiatric and physical health morbidity highlighted. Compliance with audit scores also suggested significant gaps in physical health care and monitoring. There is a need for close working relationships between the patient, carers, health and social care professionals at all levels to mitigate these issues and larger scale audits involving multiple centres are needed to further improve quality of service offered to this patient group.