Improving Prediction of Risk of Admission to Long-Term Care or Mortality Among Home Care Users With IDD

Hélène Ouellette-Kuntz, Elizabeth Stankiewicz, Michael McIsaac, Lynn Martin



Frailty is an established predictor of admission into long-term care (LTC) and mortality in the elderly population. Assessment of frailty among adults with intellectual and developmental disabilities (IDD) using a generic frailty marker may not be as predictive, as some lifelong disabilities associated with IDD may be interpreted as a sign of frailty. This study set out to determine if adding the Home Care-Intellectual and Devel-opmental Disabilities Frailty Index (HC-IDD Frailty Index), developed for use in home care users with IDD, to a basic list of predictors (age, sex, rural status, and the Johns Hopkins Frailty Marker) increases the ability to predict admission to long-term care or death within one year.


A retrospective cohort study was conducted using Residential Assessment Instrument for Home Care (RAI-HC) data for adult home care users with IDD who had a home care as-sessment between January 1, 2010 and December 31, 2013 (N = 6,169).


The HC-IDD Frailty Index was found to significantly improve prediction of transitions into LTC or death by explaining an additional 5.95% of the variance in such transitions among home care users with IDD (p value < .0001).


We recommend the use of the HC-IDD Frailty Index in care planning and in further research related to the effectiveness of interventions to reduce or delay adverse age-related outcomes among adults with IDD.


intellectual disability; developmental disability; frailty; mor-tality; long-term care; home care; aging

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ISSN: 1925-8348 (Online)