Life events and their associations with depression and anxiety in older people with intellectual disabilities: results of the HA-ID study

Hermans H, Evenhuis HM.  Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center Rotterdam, The Netherlands.  J Affect Disord. 2012 Apr;138(1-2):79-85. doi: 10.1016/j.jad.2011.12.025. Epub 2012 Feb 2.

BACKGROUND: People with intellectual disabilities (ID) may be exposed to more life events due to different living circumstances and limited coping abilities. The frequency of life events may increase with age due to age-related decline, loss of significant others and forced relocations. We studied the occurrence of life events in adults with mild to profound ID aged ≥ 50 years and their association with depression and anxiety.

METHODS: Occurrence and burden of life events were assessed with a checklist of 28 items, completed by professional caregivers. Depression and anxiety were assessed with self-report and informant-report screening instruments (n=988) and with a psychiatric interview (n=286). Associations with depression and anxiety were studied for life events in general and for specific life events.

RESULTS: 97% of the participants had been exposed to multiple life events during the preceding year and 72% had been exposed to one or more negative life events. The frequency was significantly higher in participants aged 65 years or over, in participants with mild or moderate ID and in participants with depression or anxiety. Minor physical illness and problems with a fellow resident were significantly associated with depression and anxiety, decline or loss of mobility and loss of leisure-time activities with depression and change at work or from work with anxiety.

LIMITATIONS: This study was cross-sectional and therefore lacks reliable information about causality.

CONCLUSIONS: Given the high prevalence of life events and their association with depression and anxiety, life events should be better monitored and, if possible, prevented.