Relationship Between Mobility Limitations and the Places Where Older Adults With Intellectual Disabilities Live Shaun Cleaver* † , Hélène Ouellette-Kuntz* †‡§ , and Duncan Hunter* *Department of Community Health and Epidemiology, Queen’s University; † South Eastern Ontario Community-University Research Alliance in Intellectual Disabilities; ‡ Department of Psychiatry, Queen’s University; and § Ongwanada, Kingston, ON, Canada Abstract As the population ages, mobility limitations are associated with increased mortality and negative health-related states both in the general population and among people with intellectual disabilities. The influence of mobility limitations upon the lives and lifestyles of people with intellectual disabilities remains poorly understood. Specifically, the extent to which mobility limitations might limit residential options for individuals and families has not been evaluated. To determine the relationship between mobility limitations and place of residence for adults with intellectual disabilities, age 45 and older, a proxy-response telephone survey was completed for 128 adults with intellectual disabilities in Southeastern Ontario. A participant’s place of residence was categorized as being “high support” (group homes and nursing homes) or “low support” (living alone, with family, roommates, or host family). People with a score of 12 or less on the Rivermead Mobility Index were considered to have a mobility limitation. The relationship between mobility limitations and high-support residential settings was analyzed using a multivariate logistic regression model. After adjusting for age, sex, and presence of cerebral palsy, communication problems and behavior problems, people with mobility problems had 3.6 times greater odds of living in high-support settings. Authors concluded that mobility limitations are associated with residence in “high-support” settings and that further investigation is needed to determine the direction of causality and to create programs and services that equalize opportunities. Keywords: aging, intellectual disabilities, mobility, residence, Rivermead Mobility Index INTRODUCTION The term mobility describes the human activity of moving from place to place (Bussmann & Stam, 1998). This term nor- mally refers to walking, but many people are also mobile through the use of assistive devices, such as wheelchairs or scooters. Although there is no universal definition of mobility limitation, the concept describes the immobility status of people who are unable to complete certain mobility-related tasks. The prevalence of mobility limitations is higher among older people with intellectual disabilities than it is in the general popu- lation of a similar age (Cleaver, 2007; Cleaver, Ouellette-Kuntz, & Hunter, in press). The prevalence of mobility limitations increases with age in the general population (Statistics Canada, 2007) and a similar trend is suspected for people with intellectual disabil- ities (Day, 1987; Evenhuis, 1997). With a growing population of older people with intellectual disabilities (McCallion & McCarron, 2004) this secondary disability is poised to be of substantial importance. In people with intellectual disabilities, the presence of a mobility limitation is predictive of increased mortality (Tyrer, Smith, McGrother, & Taub, 2007) and likely contributes to future health problems (van Schrojenstein Lantman-De Valk, Metse- makers, Haveman, & Crebolder, 2000). Cross-sectional studies have shown a strong relationship between mobility limitations and low bone mineral density (osteoporosis and osteopenia) (Jaffe, Timell, Elolia, & Thatcher, 2005; Tyler, Snyder, & Zyzanski, 2000). Aside from these health-related outcomes, the effects of a mobility limitation on the lives and lifestyles of people with intellectual disabilities are not well understood. In older adults without intellectual disabilities residing in nursing homes, mobil- ity has been shown to be related to a person’s sense of well-being (Bourret, Bernick, Cott, & Kontos, 2002). Mobility may also affect a person’s quality of life by influencing where he or she lives. For example, mobility status is the most important variable in deter- mining whether a person who has experienced a stroke will be discharged to his or her home or to a nursing facility (De Quervain, Simon, Leurgans, Pease, & McAlister, 1996). Received September 5, 2007; accepted March 19, 2008 Correspondence: Hélène Ouellette-Kuntz, Associate Professor, Department of Community Health & Epidemiology, Queen’s University, 191 Portsmouth Avenue, Kingston, ON, Canada K7M 8A6. Tel: +1 613-548- 4417 ext. 1198; Fax: +1 613-548-8135; E-mail: oullette@queensu.ca Journal of Policy and Practice in Intellectual Disabilities Volume 5 Number 4 pp 253–258 December 2008 © 2008 International Association for the Scientific Study of Intellectual Disabilities and Wiley Periodicals, Inc.