Using the ICF Framework to Explore Aging in People with Intellectual Disability
劉文瑜(Wen-Yu Liu)；王鐘賢(Jong-Shyan Wang)；何靖雯(Ching-Wen Ho)
智能障礙者 ； 老化 ； 國際健康功能及身心障礙分類系統 ； Intellectual disability ； Aging ； ICF
|Volume or Term/Year and Month of Publication||
38卷2期（2013 / 06 / 01）
126 - 136
背景和目的：智能障礙(intellectual disability or intellectually challenged)族群的老化(aging)問題，隨著台灣地區人民平均壽命逐漸延長而漸受重視。本報告的目的在應用「國際健康功能及身心障礙分類系統(International Classification of Functioning, Disability and Health, ICF)」架構探討智能障礙者的老化現象。方法：以描述性回顧方法，應用ICF各面向，統整目前文獻對於智能障礙族群老化問題的相關結果。結果：智能障礙在老化過程中面臨的額外「健康狀態」問題包括易提早罹患憂鬱症(depression)、失智症(dementia)、心肺疾病(cardiopulmonary ailments)、甲狀腺相關疾病(thyroid-related diseases)、關節炎(arthritis)及糖尿病(diabetes mellitus)等。「身體功能與構造」面向，與般人相比會更早出現肌力與心肺適能下降、平衡與協調不佳，以及有肥胖傾向。在「活動和參與」的面向，會提早出現行走功能與效率下降、體能活動參與降低，進而影響他們工作表現等情形，顯示有提早老化的現象。「環境因素」方面，居住環境會影響他們日常生活獨立能力。「個人因素」方面，性別及支持會影響他們健康狀況及活動參與。討論和結論：相較於一般人，智能障礙者會有提早老化的現象，因此智能障礙族群未來能邁向健康老化是相當重要的議題，除了需要其家庭成員的支持和協助，政府在醫療、教育及社政政策方面提供最佳協助以及減少不友善的環境也很重要。本研究以ICF架構分析智能障礙者老化的結果也許可做為未來智能障礙者生涯規劃及法規制定之參考。
Background and Purpose: Aging on people with intellectual disability becomes an issue with the growing life expectancy in Taiwan. The purpose of this report was to describe the aging concerns of people with intellectual disability, using the International Classification of Functioning, Disability and Health (ICF) framework. Methods: A narrative literature review was undertaken. Literatures related to aging intellectual disability were summarized by ICF domains. Results: People with intellectual disabilities are more likely to develop chronic diseases including depression and dementia, cardiopulmonary ailments, thyroid-related diseases, arthritis and diabetes mellitus at an early age. Aging process begins to affect them across several body functions and structures, such as decreased muscle power, incoordination, and deterioration of balance and cardiopulmonary functions, causing obesity, more quickly and at a younger age than their peers. In the activity and participation domains, deteriorated ambulation function and efficiency and reduced physical activity may further affect their working performance, which shows the signs of early aging. In the environmental factors, the living environment affects the level of independence in daily activities of people with intellectual disability. In the personal factors, the gender and supportive differences affects the health condition and attendance of activities , respectively. Discussions and Conclusions: In order to promote the health aging in people with intellectual disability in the future, besides the support and assistance provided by the family members, the government plays an important role in providing the optimal medical, education, and social welfare policies and decreasing environmental threats to healthy aging in people with intellectual disabilities.. This report analyzed using ICF framework may serve as the reference for future care and policy-making for older adults with intellectual disability.