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Biomedical subjects

M P Janicki

Publications and source records attributed to M P Janicki.

At least 19 recordsLinked to original sources
PubMed2003

Associations between behavior disorders and health status among older adults with intellectual disability.

Few studies have examined the relationship of behavior and health status among aging persons with intellectual and developmental disabilities (I/DD). Behavioral disorders, which often are coincident with functional decline in older persons with I/DD, may be more related to medical morbidity than previously reported. This cross-sectional study examined the association between health status and behavior disorders with increasing age in a cohort of 60,752 adults with I/DD clustered into four adult-age groupings (21-44, 45-59, 60-74, and >74). Age grouping data suggested an association between morbidity and increased likelihood of behavior symptoms in all but the oldest age grouping. The magnitude of the association and trend varied by specific disease across age groupings compared to that found in healthy cohorts. About 25% of the adults with I/DD had psychiatric diagnoses and the frequency of such diagnoses did not decrease with age grouping. These results suggest that adverse health status may increase the likelihood of persistent behavioral disturbances in older persons with I/DD. Moreover, behavioral disorders may be sentinels for occult medical morbidity, which in turn may be responsive to intervention.

Adult↗
PubMed2002

Health characteristics and health services utilization in older adults with intellectual disability living in community residences.

BACKGROUND: The health status and health needs of adults with intellectual disability (ID) change with advancing age, and are often accompanied by difficulties with vision, hearing, mobility, stamina and some mental processes. AIM: The present study collected health status information on a large cohort of adults with ID aged > or = 40 years living in small group, community-based residences in two representative areas of New York State, USA. METHOD: Adult group home residents with ID aged between 40 and 79 years (n = 1371) were surveyed to determine their health status and patterns of morbidity. RESULTS: Most subjects were characterized as being in good health. The frequency of cardiovascular, musculoskeletal and respiratory conditions, and sensory impairments increased with age, while neurological, endocrine and dermatological diseases did not. Psychiatric and behavioural disorders declined with increasing age, at least through 70 years of age. Although most conditions increased with age, their frequency varied by sex and level of ID. Frequencies of age-related organ system morbidity were compared to data from the National Health and Nutrition Evaluation Survey III. It was found that adults with ID had a lower overall reported frequency of cardiovascular risk factors, including hypertension and hyperlipidaemia, and adult-onset diabetes. Inconsistencies with mortality data among older adults with ID were observed (which showed equal if not greater prevalence of deaths as a result of cardiovascular disease and cancer). CONCLUSION: These results suggest that either a cohort effect is operating (i.e. contemporary populations are healthier than previous populations), or that there may be under-recognition of select risk factors and diseases.

Adult↗
PubMed2002

The Edinburgh Principles with accompanying guidelines and recommendations.

A panel of experts attending a 3-day meeting held in Edinburgh, UK, in February 2001 was charged with producing a set of principles outlining the rights and needs of people with intellectual disability (ID)and dementia, and defining service practices which would enhance the supports available to them. The Edinburgh Principles, seven statements identifying a foundation for the design and support of services to people with ID affected by dementia, and their carers, were the outcome of this meeting. The accompanying guidelines and recommendations document provides an elaboration of the key points associated with the Principles and is structured toward a four-point approach: (1) adopting a workable philosophy of care; (2) adapting practices at the point of service delivery; (3) working out the coordination of diverse systems; and (4) promoting relevant research. It is expected that the Principles will be adopted by service organizations world-wide, and that the accompanying document will provide a useful and detailed baseline from which further discussions, research efforts and practice development can progress.

Alzheimer Disease↗
PubMed2000

Prevalence of dementia and impact on intellectual disability services.

In a statewide survey, dementia was found in 3% of adults age 40+; 6%, age 60+; and 12%, age 80+. Among adults with Down syndrome, the rates were 22% for adults age 40+ and 56% for adults age 60+. Observed onset occurred in the mid-60s (early 50s for those with Down syndrome). Alzheimer-type dementia was the most frequent diagnosis. With the occurrence of dementia expected to rise proportionately with the increase of longevity among adults with intellectual disabilities, care systems will have to raise the "index of suspicion" among staff and families, become "dementia capable," and improve their diagnostic and technical resources, as well as their care management supports designed to prolong the "aging in place" of adults affected by dementia.

Adult↗
PubMed1996

Practice guidelines for the clinical assessment and care management of Alzheimer's disease and other dementias among adults with intellectual disability. AAMR-IASSID Workgroup on Practice Guidelines for Care Management of Alzheimer's Disease among Adults with Intellectual Disability.

The AAMR/IASSID practice guidelines, developed by an international workgroup, provide guidance for stage-related care management of Alzheimer's disease, and suggestions for the training and education of carers, peers, clinicians and programme staff. The guidelines suggest a three-step intervention activity process, that includes: (1) recognizing changes; (2) conducting assessments and evaluations; and (3) instituting medical and care management. They also provide guidance for public policies that reflect a commitment for aggressive care of people with Alzheimers's disease and intellectual disability, and avoidance of institutionalization solely because of a diagnosis of dementia.

Activities of Daily Living↗
PubMed1986

Generational trends in sensory, physical, and behavioral abilities among older mentally retarded persons.

An extensive client registry data base was used to examine whether there were identifiable patterns in prevalence of chronic disease conditions, in decline of sensory capacities, and in decline of behavioral abilities among 10,532 elderly mentally retarded persons born between 1890 and 1939. Data indicated identifiable patterns in the prevalence of chronic disease conditions (cardiovascular, digestive, musculoskeletal, and respiratory systems) and the decline of behavioral and physical abilities and sensory capacities with increasing age. Functional skill losses were most prominent in mobility and fundamental activities of daily-living skill areas. Some behavioral losses were noted to occur earlier than would be expected in the general population; however, as with nonretarded persons, decline was highly variable and linked to the aging process experienced by each older retarded person. Implications of the findings were discussed.

Activities of Daily Living↗
PubMed1985

Clinical need variations of disabled persons residing in group homes.

Group home research has generally entailed comparison of these settings and their residents to institutions and their residents. Group home residents have frequently been treated as a homogeneous cohort of individuals. When group home development began, initial residents--usually individuals recently deinstitutionalized--were probably relatively homogeneous in regard to functional abilities and service needs, and generally similar to other disabled persons living in the community. Today, the residents of one group home may bear little resemblance to those of another. This report presents information about the types of group homes within a state system based upon the characteristics and service needs of 1,050 persons in 118 group homes and questions the role of community mental health centers in addressing certain service needs of group home residents.

Analysis of Variance↗
PubMed1984

Characteristics of New York's community residences for developmentally disabled persons.

A statewide survey of New York's community residences for developmentally disabled persons was conducted in which program auspice, history and affiliation, physical structure, community relations, residence staff, and occupant characteristics were examined. The results revealed a diverse system, with certain characteristics similar to those reported in previous national community residence surveys. Principal differences between the statewide data and the national surveys related to residence auspice, size, and staff demographics. These differences are explained as a function of both survey sampling strategies and program differences. Implications of the data are discussed.

Adolescent↗
PubMed1983

Variations in characteristics and service needs of persons with autism.

Information concerning socio-demographics, disability characteristics, and services received and needed became available on approximately 900 autistic children and adults as a result of a statewide needs assessment and case-finding collection project conducted in New York. Analyses of the results confirmed other findings as to the predominance of males to females and a high concomitant occurrence of mental retardation. Results also showed a population having few problems with mobility, hearing or vision, but moderate deficits in most skills related to activities of daily living, and significant deficits in communication and basic independent functioning skills. Differences were observed between institutionalized and noninstitutionalized autistic persons in terms of level of retardation, functional skills, age, and use of medications. Implications of the findings are drawn for clinicians, administrators, and public policy makers.

Activities of Daily Living↗
PubMed1983

Self-preservation ability and residential fire emergencies.

Perske's concept of risk from the perspective of fire safety was examined for approximately 46,000 developmentally disabled persons. The National Bureau of Standards measurement of self-preservation ability was used to define individual risk, resulting in the Evacuation Assistance Score. Environmental risk was measured by grouping residences according to fire safety standards described in the National Fire Protection Association's Life Safety Code. Results indicated that: (a) the Evacuation Assistance Score is best thought of as a single variable that measures any risk that might impede a resident's safe evacuation in a fire emergency, (b) the majority of the developmentally disabled individuals receiving services in New York were totally capable of self-preservation, (c) resident demographic characteristics were not strong predictors of Evacuation Assistance Scores, and (d) the match between individual and physical environment risk vulnerability was not strong.

Adolescent↗