Growing Older with A Developmental Disability:
Physical and Cognitive Changes And Their Implications
Alan R. Factor, Ph.D.
Rehabilitation Research and Training Center
On Aging with Mental Retardation
Institute on Disability and Human Development
University of Illinois
Funded by the U.S. Department of
Education, Office of Special Education and Rehabilitative Services, National
Institute on Disability and Rehabilitation Research Grant
No. H1331330069, the Illinois Department on Aging/Administration on Aging Grant
No. 90AM0681, and the Administration on Developmental Disabilities, Aging Training
Initiative Project Grant No. 9013130290.
This document has been reprinted by the Center on Human Development and
Disability, University of Washington with the permission of the Rehabilitation
Training Center on Aging with Developmental Disabilities.
Factor, A. R. (1997). Growing Older with a Developmental
Disability: Physical and Cognitive Changes and Their Implications. Chicago:
Research and Training Center on Aging with Mental Retardation, University
This is a publication of the Rehabilitation Research and Training Center
on Aging with Mental Retardation. The opinions contained in this publication
of the grantee and do not necessarily reflect those of its funding
THE AGING PROCESS
Why is old age a time of physical and men al decline?
Aging is an ongoing lifelong process that starts in the womb. There are three
stages: 1) fetal growth, 2) maturation, and 3) senescence. Senescence refers
to the physical and mental changes that occur in later life.
How long do people live?
The life span for human beings is approximately
120 years. Life span is the maximum length of time that humans could
live if all illnesses and accidents could be avoided or could be successfully
treated. There is no evidence that life span has increased over the
centuries. Life expectancy is the average number of
years an individual is actually likely to live. Life expectancy has
increased because, even though we have not slowed senescence, we have
reduced early death through medical advances, better access to health
care, and improvements in public health. The life expectancy for males
born in 1983 is 71 years compared to only 46 years for males born in
1900 (Schaie & Willis, 1991).
What is the life expectancy for people with mental retardation?
The life expectancy for people with mental retardation
without Down syndrome who have mild to moderate levels of impairment
approximates that of the general population. A recent study of New
York State mortality data for 2,752 adults age 40 and older with mental
retardation revealed their average age at death was 65 compared to
age 70 for the general population. Heart disease, pneumonia, and cancer
were the leading causes of death. Paralleling general population trends,
males died earlier (age 63) than females (age 67). People with Down
syndrome died on average ten years earlier (age 56) (Janicki, 1996)
Why is old age a time of physical and mental decline?
The research supports two general theories that help
explain why we age. Programmed theories attribute
aging to a biological timetable, possibly the same one that regulates
childhood growth and development. Age-related deficits are theorized
to result from internalized biological clocks which program changes
in our genes, hormones, and immune system functions.
Error theories suggest that aging is
caused by external or environmental factors that damage cells and organs
until they can no longer function adequately. For example, various
error theories suggest that we age because vital cell parts wear out
or genetic mutations occur (National Institute on Aging, 1993).
Compared to the general population, we have relatively
limited information on the age-related physical and mental changes
that people with developmental disabilities experience. Most research
has been based on small numbers of people who were not followed over
a long period of time. Much of the early research was conducted in
large institutions and probably included unusually high percentages
of people with severe levels of impairment and serious medical problems.
Nonetheless, we have been able to identify similarities as well as
distinct differences in how people with developmental disabilities
What health problems are adults with mental retardation
(without Down syndrome) likely to develop as they grow older?
After age 50, people with mental retardation and people
in the general population are more likely to develop chronic diseases
including diabetes, arthritis, cancer, and respiratory ailments. Heart
disease also is more prevalent among both groups, although angina (severe
chest pain) may be less frequent among people with mental retardation.
It is unclear, however, whether older people with mental retardation
actually are less likely to experience this condition or whether it
is less likely to be detected and reported. After age 70, constipation
is a greater problem for people with and without mental retardation.
Obesity and osteoporosis (brittle bones) are two conditions
that appear to be more prevalent among older individuals with mental
retardation than among other older people. Osteoporosis is a particular
concern because older people are more at risk of falling due to mobility
and balance problems.
Certain age-related changes may occur earlier among adults
with mental retardation. They may experience vision and hearing losses
earlier. People who are unable to walk and who have a profound level
of impairment are more likely to die earlier from respiratory infections
(Machemer,Jr. & Overeyender, 1993; Schrojenstein Lantman, et al,
What mental changes occur, as adults with mental- retardation
Like the general population after age 50, people with
mental retardation, who do not have Down syndrome, experience a gradual
decline in overall intellectual capacity, a decrease in their speed
of recall, and slower general cognitive functioning.
Mental illness is more prevalent among adults with mental
retardation than it is in the general population. Possible contributing
factors are limitations in expressive communication, deficits in information
processing, and a lack of social acceptance. Depression is the most
frequently diagnosed affective disorder among older people with mental
retardation, and it can be triggered by situations that would be less
stressful to the general population. Individuals with mild and moderate
levels of impairment are more likely to develop anxiety disorders and
phobias than are people with severe impairments (McNellis, 1997; Moss,
Often, it is difficult to identify mental health problems
among older people with mental retardation. People with mental retardation
are less able to describe and convey their feelings; symptoms of certain
conditions such as depression may be expressed as physical complaints
(e.g., headaches). Detection of mental health problems also varies
by the degree of access to the service system.
How are adults with Down syndrome affected by the aging
People with Down syndrome are susceptible to premature
aging. Age related physical changes that generally begin after age
55 in the general population often occur among people with Down syndrome
who are in their early forties.
At this age, individuals with Down syndrome are more
likely to experience the early onset of hearing losses, vision problems
including cataracts, and the premature aging of their immune system.
They also are more susceptible to obstruction of their airways which
causes sleep apnea, and 20 to 30% may develop hypothyroidism which
reduces the production of thyroid hormones. As adults with Down syndrome
grow older they are at greater risk for joint problems of the neck,
knee, or hip and for bunions, any of which can pro-duce difficulty
with walking and balance. They also are more likely to develop seizures
(possibly related to Alzheimer's disease), tumors, and heart disease.
Approximately 40% of people with Down syndrome are born with congenital
heart problems that may become more severe in later life. However,
they appear to be less susceptible to hypertension.
Individuals with Down syndrome may begin experiencing
adaptive skill losses and intellectual decline at approximately 50
years of age, earlier than either the general population or other people
with mental retardation (Adlin, 1993; Cohen, 1996).
What age-related changes are people with cerebral palsy
likely to experience?
People with cerebral palsy are likely to experience the
onset of several secondary conditions as they grow older. These include
reduced mobility due to pain and/or weakness in the joints and muscles,
and difficulty in eating and swallowing due to loss of control of the
throat muscles. Individuals also report problems in breathing and muscle
control, which make speaking more difficult. Adults experiencing ongoing
bowel and bladder problems often report these problems increase as
they grow older. As people with cerebral palsy age they also are at
greater risk than the general population for osteoporosis, periodontal
disease and pressure sores. Clinical management can help reduce some
of these age-related secondary conditions. For example, a physiatrist
and a physical therapist can implement conditioning programs to 1)
improve stamina and the cardiovascular system, 2) reduce spasticity
and muscle pain, and 3) strengthen muscles (Overeynder, Janicki & Turk,
1994; Turk & Machemer, Jr., 1993).
The Normal Aging Process and Unique Considerations for
Adults with Developmental Disabilities
Genetics, environment, and lifestyle choices affect how
all people age. How people with developmental disabilities age is additionally
affected by the nature and severity of their impairments, secondary
conditions arising from the inter-action of the aging process with
their developmental disability, coexisting medical conditions, and
their medication usage. Therefore, caregivers need to understand 1)
how the general aging process affects the body systems and 2) the differences
that may occur among people with developmental disabilities.
The following pages contain detailed descriptions of
the age-related physical and mental changes that people with developmental
disabilities are likely to experience, based on the research to date.
Information is provided that 1) describes the normal aging process
that all individuals experience; 2) specifies unique characteristics
exhibited by older adults with mental retardation (with and without
Down syndrome) and older adults with cerebral palsy, the two most prevalent
conditions resulting in a developmental disability; and 3) provides
suggestions on how family, friends, and staff can support individuals
when they experience these changes.
Adlin, M. (1993). Health care issues. In Sutton,
E., Factor, A., Hawkins, B., Heller, T., & Seltzer, G. (Eds.). Older
adults with develop-mental disabilities: Optimizing choice and change. Baltimore:
Paul H. Brookes Publishing Co.
Cohen, W.I. (1996). Health care guidelines
for individuals with Down syndrome. Down Syndrome Quarterly, _1 (2), 1-10.
M.P. (1996, Fall). Longevity increasing among older adults with an intellectual
disability. Aging Health, and Society, 2,2.
McNellis, C.A. (1997). Mental
aging: Mental health issues. Gerontology and Geriatrics Education, 17 (3),
Moss, S. (1997, January). Mental and physical
health of older people with intellectual disability (mental retardation).
National Institute on Aging (1993). In search
of the secrets of aging. NIH Publication No. 93-2756. Washington, DC: U.S. Department of
Overeynder, J.C., Janicki, M.P., Turk, M.A. (Eds.) (1994). Aging
and Cerebral Palsy-pathways to successful aging: The national action
York State Developmental Disabilities Planning Council.
Schaie, K.W. & Willis,
S.L. (1991). Adult developmental and aging (3rd ed.). New York: Harper Collins.
Lantman-deValk, H.M.J. van, Akker, M. van den, Maaskant, M.A., Haveman, M.J.,
Urlings, H.F.J., Kessels, A.G.H., & Crebolder, H.F.J.M.
(1997). Prevalence and inci-dence of health problems in people with intellectual
disability. Journal of Intellectual Disability Research, 41 (1), 4251.
M.A. & Machemer, Jr., R.H. (1993). Cerebral palsy in adults who
are older. In Machemer, Jr., R.H. & Overeynder, J.C. (Eds.). Understanding
aging and developmental disabilities: An in-service curriculum (pp111-129).
Rochester, NY: Strong Center for Developmental Disabilities, University of
Rochester School of Medicine and Dentistry.
The Aging Process Page 5
People lose the ability to see images clearly
(visual acuity), as the lens of the eye becomes denser and cloudier.
are less able to focus on items close-up (presbyopia), as the lens
becomes more rigid. People who are nearsighted will need bifocals.
greens, and violets are harder to distinguish because the yellowing
of the lens distorts color perception.
People lose peripheral (side) vision
as the retina changes.
People find it more difficult to adapt to and
see in the dark because the pupil becomes smaller with age.
are less able to adapt to glare.
Dry eyes (scratchy, irritated eyes)
and blepharitis, (inflammation or infection of the eyelids) are eye
are more likely to occur as people
age and may impair vision.
Age-related eye diseases
such as macular degeneration (results in the loss of central vision),
glaucoma (results in the
loss of peripheral
keratoconus (the thinning of the cornea),
and cataracts can seriously impair vision.
Many older people develop diabetes,
which causes a loss of visual acuity.
for People with Developmental Disabilities
Adults with Down syndrome are at higher risk for vision
problems and are more likely to experience age-related eye disorders earlier
Blepharitis, keratoconus and cataracts are more common
among adults with Down syndrome.
Because many vision changes occur gradually,
individuals may have difficulty recognizing or communicating the problem.
Suggestions for Carers
Provide periodic eye exams.
Watch for behaviors suggesting
vision problems such as: squinting, confusion, rubbing the eye, shutting/covering
one eye, tilting /thrusting
the head, holding objects closer.
Use bright (e.g., yellow, orange,
red) and contrasting colors.
Use contrasting colors or different textures
at stairs and other places to accommodate declines in depth perception.
lighting levels and arrange lights to focus on individual tasks.
nightlights and large print books.
Allow time for a person to adjust
to changes in light.
Reduce glare by using dull instead of highly
polished finishes on furniture and
The Aging Process Page 7
High-pitched tones become harder to hear.
The onset of this condition, called "presbycusis",
often occurs when people are in their mid 50's. It worsens with
Presbycusis results in the "Cocktail Party Effect".
People find it harder to listen to one person's voice when there
lot of background
Considerations for People with Developmental Disabilities
with Down syndrome are generally more prone to hearing loss because
of the presence of fluid in the middle ear and very small ear canals
which can be blocked by relatively small amounts of cerumen (ear
Presbycusis is more prevalent among people with Down syndrome
and often occurs among young adults.
Suggestions for Carers
Be alert for signs of hearing loss such
as boosting the television volume, speaking loudly, withdrawing
from social situations.
Periodically check for cerumen (wax) in the ears.
may be correctable with a hearing aid.
Look directly at the person when
speaking. Speak clearly and slowly in deeper tones.
Find a quiet place
with minimum background noise for conversing.
Allow the person time
to sort out what he or she has heard.
The Aging Process Page 8
TASTE AND SMELL
Taste buds wither and reduce the sense of
The senses of sweet and sour taste are lost first. The
sense of bitter taste remains the longest.
The sense of smell may also be
The thirst mechanism may decline causing dizziness from
Use more seasoning on foods but avoid salt.
change in taste may also be related to medication or to illness.
sure that liquid intake is sufficient to prevent dehydration.
individuals for odors on their clothing and body.
Make sure smoke detectors
Check for spoiled food.
The Aging Process Page 9
The skin becomes thinner and dryer and develops
The loss of the layer of fat just below the skin decreases
our ability to stay warm in cooler temperatures.
The sweat glands lose
their ability to keep us cool in hotter temperatures.
(aging spots) increase.
The skin loses its ability to feel pain and
a light touch.
for People with Developmental Disabilities
Dry skin is very
common in adults with Down syndrome, especially if
they have hypothyroidism.
Fungal infections of the skin and nails are more
prevalent among people with Down syndrome.
People with cerebral palsy
are more susceptible to pressure sores because of decreased mobility
and the thinning of
their skin. Suggestions for
Thoroughly and gently rinse away soap to prevent dry
and flaky skin.
Thoroughly and gently dry the skin and apply
People who can't move by themselves should
be frequently repositioned to prevent pressure sores.
skin for dryness, pressure sores, cuts, and burns.
Be aware of sudden
changes in air
Make sure hot and cold water
faucets are easy to identify and easy to turn on
because older people
feel heat less quickly. Monitor bath water and heating pad
temperatures to prevent burning.
The Aging Process Page 10
MUSCLES AND BONES
Muscle mass decreases and muscles lose their strength and
Joints become less mobile.
Bones become more porous and easier to
Women are at much greater risk for osteoporosis
because of the loss of estrogen that
The spinal cord shortens with age.
are more likely to develop arthritis.
Considerations for People with Developmental
Approximately 14% of people with Down syndrome have spinal
which may compress
the spinal cord, possibly resulting in neck pain,
and gait, loss of upper body strength, abnormal neurological
reflexes, and changes
and bladder discharge.
Adults with Down syndrome are susceptible
to problems with walking and balance because they are at greater
joint problems of the neck,
hip and for developing bunions.
Individuals with a
long-term history of taking anti-seizure medication have a greater
risk of developing osteoporosis.
Nutritional deficits, limited muscle activity,
and medication usage also place people with cerebral palsy at
risk for developing osteoporosis.
Individuals with cerebral palsy
are likely to experience reduced mobility due to pain
and/or weakness in the joints
This can result
from long-term weight bearing on poorly
developed joints and aggressive therapy
regimens to encourage walking.
Suggestions for Carers
Encourage independent movement and self-care
Promote regular exercise (weight bearing if possible).
safeguards such as stair railings, non-slip risers on stairs, and non-skid
strips in bathtubs
to prevent falls.
Teach individuals to use mobility aids appropriately
to reduce the risk of injury and falls.
seating that is comfortable but firm and not too deep.
reducing osteoporosis include increased calcium intake,
weight bearing exercises,
The Aging Process Page 12
HEART AND BLOOD VESSELS
The heart rate decreases because the heart muscles
get weaker and don't contract as quickly.
the heart rate is elevated, it takes longer for it to return to normal.
factors cause the arteries to harden (become less elastic): 1) agerelated
2) the build up of fat
(cholesterol) on the artery walls,
a condition called atherosclerosis.
arteries harden, the heart must pump faster in order to maintain the
flow of blood
for People with Developmental Disabilities
An estimated 30% to 60% of people
with Down syndrome are born with heart problems (congenital heart disease),
with no history of
may develop heart valve dysfunction. Adults with
these conditions may develop special needs as they grow older.
with Down syndrome are
at low risk for atherosclerosis.
Undertake activities at an appropriate pace for
Teach people how to conserve
Watch for signs of fatigue, decreased endurance,
dizziness, confusion, and distress.
enough time between position changes to prevent dizziness.
objects at waist level or below to eliminate lifting them over
Encourage moderate exercise on a
Encourage a reduction
in cigarette smoking.
Implement a diet that increases "good" cholesterol
and reduces "bad" cholesterol.
Provide routine blood pressure
tests, and implement a low salt diet
to reduce high
signs and the symptoms of a heart attack.
The Aging Process Page 14
LUNGS (PULMONARY SYSTEM)
Our lungs become less elastic, which reduces
the amount of oxygen taken in. However, the limiting
take in oxygen,
ability of the heart to circulate it.
Our breathing becomes less efficient, and
our tolerance for exercise decreases.
for People with Developmental Disabilities
Encourage people to stop smoking and
to avoid second hand smoke.
v Encourage deep breathing.
Reduce the pace of activities
and allow more frequent
Help individuals alleviate stress.
Make sure that people
are eating properly and drinking
for influenza, pneumonia, and
for signs of infection
in coughing, shortness
sputum, and increased confusion.
The Aging Process Page 15
DIGESTIVE (GASTROINTESTINAL) SYSTEM
- Total calorie needs decline with every decade.
- Indigestion and ulcers may
increase because less gastric juice is being produced.
- The decrease in saliva
production puts us at greater risk for gum (periodontal) disease.
Considerations for People with Developmental Disabilities
- Older people with
developmental disabilities are at greater risk for severe problems from
constipation. Long-term poor toileting habits may cause individuals
to have expanded (distended) and poorly functioning bowels. People who
are inactive or who take antidepressants, antipsychotic, anticonvulsant,
medications are more likely to develop constipation.
- People with cerebral
palsy and with Down syndrome may experience difficulty with eating and
swallowing due to a loss of control of their throat muscles.
Individuals with a high degree of spasticity can be at risk of choking.
bowel and bladder problems that are experienced by many people with cerebral
palsy will intensify with age. Decreased movement and reduced
and fiber intake make people with cerebral palsy especially prone to
- Individuals with cerebral palsy and individuals with Down
syndrome are at greater risk for gum disease than the general population.
Suggestions for Carers
- Provide a balanced diet that includes high fiber foods and nutrient dense
- Implement a regular schedule for using the toilet.
- Promote good oral hygiene
and periodic dental exams.
- Periodically evaluate dentures for good fit and
encourage good cleaning. Poor fitting dentures can cause soreness that
limits a person's ability
to properly chew food. People will avoid nutritious foods that require
- Refer people with incontinence problems and with swallowing
problems for medical evaluations.
The Aging Process Page 17
- Bladder capacity and muscle tone decrease causing people
to urinate more frequently. However, urinary incontinence (the involuntary
loss of urine) is not a normal
part of aging.
- The kidneys become less efficient in removing wastes from the
blood. Between the ages of 20 and 90, the kidney filtration rate drops
by nearly 50%.
- In men, enlargement of the prostate gland can restrict urinary
for people with developmental disabilities
- Urinary incontinence may be more
prevalent among people with Down syndrome. Predisposing factors include urinary
tract infections, nervous system disorders,
behavior issues, and variations in the body structure.
- For people with cerebral
palsy, spasticity results in urinary retention and curvature of the spine
(stenosis) can result in incontinence.
- Make sure that toilet facilities are nearby and can be quickly accessed.
regular reminders to use the toilet.
- Encourage a fluid intake of eight glasses
each day unless restricted by doctor's orders.
- Evaluate incontinence problems.
For example, increased frequency of urination may be a symptom of diabetes.
for prostate cancer and diabetes.
The Aging Process Page 18
GLANDULAR (ENDOCRINE) SYSTEM
- The endocrine system's production of hormones (chemical messengers)
- The pancreas releases less insulin into the blood stream. This
results in excess blood sugar and may lead to diabetes.
- Hormones that stimulate
the immune system begin to decrease, although the decline is more gradual
in males than in females.
- There is a decrease in
to respond to stress.
- It is more difficult to maintain body temperature.
- The body's processes
(metabolism) become less efficient.
- Females experience the onset of menopause
at approximately age 50 (around age 45 for females with Down syndrome), which
triggers the reduction in hormone
production and the stop of menstrual periods. Decreased estrogen production
causes the vaginal walls to become thinner and drier. Signs of menopause
hot flashes, sleep difficulty, and emotional changes.
- Testosterone production
decreases during "male menopause," and
men may experience depression, anxiety, and fatigue.
Considerations for People with
- People with Down syndrome may experience the premature
aging of the immune system.
- Some studies suggest women with Down syndrome
and women who have seizures may experience menopause earlier. The frequency
of seizures also may change as
women go through menopause.
- From 20% to 30% of people with Down syndrome
may develop hypothyroidism (insufficient production of the thyroid hormones).
Symptoms can include lethargy, functional
decline, confusion, constipation, dry hair and skin, fatigue, and depression.
If hypothyroidism is untreated, it can lead to hallucinations and to
- Teach individuals about the changes that take place when we age.
and provide gynecological exams to women.
- Explain and provide prostate exams
to men who are 50 or older.
- Minimize physical, mental and emotional stress.
- Make sure individuals receive
immunizations such as the Hepatitis B vaccine.
- Monitor the person's body
temperature and his/her comfort.
- Oversee clothing choices to avoid hypothermia
(getting too cold) or heat strokes (getting too hot).
- Encourage companionship,
friendships, and social activities that are based on the individual's preferences.
that all individuals have sexual feelings and help individuals to express
these feelings appropriately.
- Provide education about HIV/ AIDS.
The Aging Process Page 20
- There is a decrease in "sound" sleep.
- People are more likely to
wake up during the night.
- The amount of time spent sleeping is reduced.
Considerations for People with Developmental Disabilities
- People with Down
syndrome are more likely to develop sleep apnea (obstruction of the airway
evidenced by loud snoring and pauses in breathing during
sleep) because they have the following predisposing characteristics:
unusually small upper airways, increased secretions, obesity, poor muscle
tone, tongue weakness, and enlarged tonsils
and adenoids resulting
from frequent infections.
- Since people with Down syndrome have so many
predisposing characteristics, the prevalence of sleep apnea is likely to
increase as they age. Symptoms
of sleep apnea include excessive daytime sleeping, behavioral disturbances,
declining functional skills, and disrupted sleep patterns.
- Encourage a regular sleep routine.
- Reduce the intake of caffeine and fluids
- Discourage the use of sleeping pills. Instead, try methods
to promote sleep including relaxation techniques and warm milk.
- Watch for
signs of sleep apnea such as excessive daytime sleeping, behavioral disturbances,
skill decline and disrupted sleep patterns.
The Aging Process Page 21
- Changes in the liver, kidney and gastrointestinal systems affect the
body's ability to absorb, distribute, and eliminate medications.
- The risk
of side effects from medication increases with the number of drugs an individual
Suggestions for Carers
- Make sure that every physician knows about all the medications
an individual is taking.
- Know what each medication does and what the possible
side effects are. Start with a low dosage of a new medication and slowly
- Watch for unexplained and unusual symptoms.
- Check for drug to drug interactions
and food to drug interactions.
The Aging Process Page 22
BEHAVIORAL AND COGNITIVE CHANGES
- Intelligence, or the ability to learn, does not necessarily
decline in old age. Loss of intellectual abilities tends to be more related
to low motivation,
health problems and social isolation than to age.
- Older people have more
difficulty in processing and organizing new information. This also makes
it more difficult to recall things.
- It is harder for older people to recall
people, places and things than it is to recognize them because recognition
is aided by what we see.
is the same throughout our life. But, our personality traits are accentuated
- The risk factors for mental illness appear to vary with age,
but it is uncertain how they affect the prevalence of mental illness.
Considerations for People
with Developmental Disabilities
- Small, insignificant increases in motor problems
may be exhibited by adults without Down syndrome after age 50.
without Down syndrome may experience a gradual decline in intellectual
capacity and the speed of recall.
- Individuals with Down syndrome begin to
show losses in cognitive and adaptive skills by age 50.
- The onset of Alzheimer's
disease may occur at a younger age and may result in a more rapid decline
among people with Down syndrome than in the general
- Mental illness is more prevalent among people with mental
retardation than among the general population.
- Depression is the most frequently
noted affective disorder among older people with mental retardation.
with mental retardation are more likely to become depressed from less stressful
situations than the general population.
- Anxiety disorders and phobias are
more common among people with mild and moderate levels of impairment.
Suggestions for Carers
- Establish routines in the activities of daily living.
- Use memory aids and
familiar objects to help a person learn new tasks and remember old ones.
slowly, clearly and distinctly.
- Ask simple questions and give simple instructions.
- Provide environmental
cues (e.g. changing the color of the walls and the flooring to differentiate
- Refer individuals showing signs of Alzheimer's/ dementia for a thorough
clinical evaluation to rule out treatable conditions that produce
the same symptoms.
These include: hypothyroidism; B-12 deficiency; brain tumor; stroke;
kidney; liver and electrolyte disturbances; medication effects;
changes; and sleep apnea.
The Aging Process Page 24
PROMOTING GOOD HEALTH
- Encourage proper nutrition.
- Incorporate exercise into the daily routine
and into residential activities. For example, make it a habit to exercise
while TV commercials are on and
to walk rather than drive to the store.
- Motivate people to exercise by relating
exercise to their goals for achieving and maintaining good health.
- Begin a
walking regimen with two minutes initially, building up to 15 after two-three
months; add flexibility exercises and light weight training.
Disguise" exercise through walking in malls, museums, zoos, etc. Put
up a basketball net; use lively, easy to follow exercise videos; utilize
fitness centers. People will continue to exercise if it is fun.
participation in activities by charting and posting the individual's progress.
hiring staff, try to recruit individuals who have a personal interest and
commitment to fitness.
- Contact local resources such as your school district's
adapted physical education programs, college physical education departments,
and special recreation associations
for help in establishing your exercise programs.
The Aging Process Page 25
Physical Health Resources
The following material is available from the Institute
on Disability and Human Development's RRTC Clearinghouse on Aging and Developmental
W. Roosevelt Road, Chicago, IL 60608, (800) 996-8845 Voice; (800) 526-0844
Illinois Relay Access:
- Promoting Health in Adults with Down Syndrome. Chicoine, B., & McGuire,
D. (1996). $3.00.
- Aging with Developmental Disabilities: Changes in Vision.
Flax, M. E., & Luchterhand,
C. (1996). $2.00; quantities of 100 available for $26.00.
- Assistive Technology
and You: A Guide for Families and Persons with Disabilities. Hedman, G.,
Hooyenga, K., Politano, P., & Sposato, B. (1997). $10.00. McCracken
Intervention Matrix: Guidelines for Careers to Help Older Adults with Mental
Retardation Maintain Optimal Functioning. McCracken, A., & Lottman, T.
- Aging with Developmental Disabilities: Aging, Mental Retardation
and Physical Fitness. Rimmer, J. (1997). $2.00; quantities of 100 available
- Hearing Changes i8n Aging People with Mental Retardation, Bagley,
M. & Mascia,
J. (1999). $2.00; quantities of 100 available for $26.00.
- Aging with Developmental
Disabilities: Women's Health Issues, Brown, A. & Murphy,
L. (1999). $2.00; quantities of 100 available for $26.00.
The following materials
are available free of charge from The Arc of the United States, 500 East Border
Street, Suite 300, Arlington, TX 76010, (800) 433-5255:
- Developmental Disabilities
and Alzheimer's Disease... What You Should Know.
- Physical Fitness in People
with Mental Retardation.
- Let's Talk About Health: What Every Women Should
Know (Gynecological Exams, Health Checkups, Menopause, etc.). $28.00 This
kit contains a video, audio
tape, and booklet.
The following are examples of health care publications that
are available free of charge from the American Association of Retired Persons
(HARP). To order,
write or fax HARP: 609 E. Street, NW, Washington DC 20049; FAX (202) 434-6466:
Are... You Need a Mammogram (D14502).
- Taking Care of Yourself... Includes
Breast Health Too (D16335).
- Have You Heard? Hearing Loss and Aging (D12219).
List for the Deaf and Hearing Impaired (D14925).
- Developing Fall Prevention
Programs for Older Adults (D15236).
- Healthy Questions:
How to Talk to and Select
Physicians, Pharmacists, Dentists, and Vision Specialists (D12094).
Strong for Men Over 50 (D15296).
- Action for a Healthier Life: A Guide for
Mid-Life and Older Women (D13474).
- Healthy Eating for a Healthy Life (D15565).
Doable, Renewable Home (D12470).
Aging with Developmental
Disabilities: A Guide For Families. Alfassa-White, R., & Bloom, P. (1996).
Available in Spanish and English. The University of Miami/ Center on Aging
and Developmental Disabilities, 1400 N.W. 10th Avenue,
Suite 601, Miami, FL 33136. (305) 243-6397.
Age Pages (1995, October). A series
of 50 publications that provide a quick, practical look at health topics of
interest to older people. The Age Pages
are free. Call National Institute on Aging Information Center at (800) 222-2225
Voice; (800)222-4225 TTY.
Resource Directory for Older People. National Institute
on Aging (1996, March). National Institute on Aging. Call NIA Information
Center at (800) 222-2225 Voice; (800)222-4225 TTY.
Active Living with Arthritis. Advil
Forum on Health Education, 1500 Broadway, 25th Floor, New York, NY 10036.
and Cerebral Palsy - Pathways to Successful Aging: The National Action Plan.
Overeynder, J.C., Janicki, M. P., & Turk, M. A. (Eds.). (1994). New
York State Developmental Disabilities Planning Council, 155 Washington Ave.,
Albany, NY 12210. (518) 432-8233 Voice; (518) 432-8245 TTY.
Cerebral Palsy and
Aging: A Report to Adults with Cerebral Palsy and Their Families. Arcand,
M. (1996). Wisconsin Council on Developmental Disabilities
P.O. Box 7851, Madison, WI 53707. (608) 266-7826 (V) or (608) 266-6660 (TTY).
Disease Education and Referral Center, National Institute on Aging, P.O.
Box 8250, Silver Spring, MD 20907-8250. (800) 438-4380.
and Down Syndrome. National Down Syndrome Society. (800) 221-4602.
Guidelines for the Clinical Assessment and Care Management of Alzheimer and
Other Dementias Among Adults with Mental Retardation. Janicki, M. P., Heller,
T., Seltzer, G. B., & Hogg, J. (1995). American Association on Mental Retardation,
Attn: Alzheimer Disease Work Group, 444 North Capitol Street, N.W., Suite 846,
Washington, DC 20001.
Diagnosis of Dementia in Individuals with Intellectual
Disability. Aylward, E.H., Burt, D.B., Thorpe, L.U , Lai, F., & Dalton,
A.J. (1995). American Association on Mental Retardation, Attn: Alzheimer Disease
Work Group, 444
North Capitol Street, N.W., Suite 846, Washington, DC 20001.
Alzheimer's Patients: A Selected List of Resources (1992); Alzheimer's Association
Publications Catalogue (1997). Benjamin B. Greenfield National
Alzheimer's Library and Resource Center, Alzheimer's Association, 919 N. Michigan
Ave., Chicago, IL 60611-1676. (800) 272-3900.
Health, Fitness, and Quality of
Life for Older Adults with Developmental Disabilities. Hawkins, B. A.
(1996). A chapter in Older Adults with Developmental Disabilities
and Leisure, by Tedrick, T. (Ed.). The Haworth Press, 10 Alice Street, Binghamton,
Fitness and Rehabilitiation Programs for Special Populations. Rimmer,
J. H. (1994). Brown and Benchmark Publishers. BRBK Select, 2460 Kerper Blvd.,
IA 52001. (800) 338-5578. $36.00.
Don't Be Surprised, You Can Find a Healthy Lifestyle" (NADS 30 minute
aerobic video and accompanying booklet). National Association for Down Syndrome,
P.O. Box 4542, Oak Brook, IL 60522. $35.00.
Health Promotion for Older Persons
with Developmental Disabilities: Depression. Teri, Linda (1997). Northwest
Geriatric Center, University of Washington, Box
358123, Seattle, WA 98195. (206) 685-7478. $8.50.
Health Promotion for Older
Persons with Developmental Disabilities: Osteoporosis. LaCroix, Andrea
Z. (1997). Northwest Geriatric Center, University of Washington,
Box 358123, Seattle, WA 98195; (206) 685-7478. $8.50.
Recovering After a
Stroke. Agency for Health Care Policy and Research. (1995). AHCPR, P.O. Box
8547, Silver Spring, MD 20907; (800) 358-9295. Free.
to Help People with Impaired Vision: Consumer Catalog (request most current).
The Lighthouse Inc, 36-20 Northern Boulevard, Long Island, NY 11101.
To obtain copies of this publication contact:
on Aging & Developmental
RRTC on Aging with Mental Retardation (M/C 626)
of Illinois at Chicago
1640 West Roosevelt Road
Chicago, IL 60608-6904
Clearinghouse is a resource for information and products related to aging
and developmental disabilities and disseminates products developed by the
Rehabilitation Research and Training Center on Aging and Mental Retardation.
more information, call:
Local: (312) 413-1860 (V); (312) 413-0453 (TTY)
Chicago: (800) 996-8845 (V); (800) 526-0844 (TTY); FAX: (312) 996-6942
Visit us on the web at http://www.uic.edu/orgs/rrtcamr/index.html
This document is being presented by the Center on Human Development
and Disability, University of Washington with the permission of the Rehabilitation
and Training Center on Aging with Developmental Disabilities.
to AEDD home page
Copyright © 2005 by University
of Washington. Permission is granted to copy all materials written by the University
of Washington for educational, noncommercial purposes provided the source is acknowledged.
See Copyright Statement for more information.