Defining fragility of the elderly severely mentally handicapped according to mortality risk, morbidity, motor handicaps and social functioning*

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Abstract
The main aim of this study was to find a cut-off point in the age-distribution at which the physical fragility of the severe mentally handicapped residents increases. The following criteria for age-related fragility were used: mortality risk, morbidity rates of chronic diseases, motor problems and social functioning. The age-specific mortality risks were computed by means of data of the National Case register in the period 1978-1983. The morbidity-rates, rates of motor handicaps and handicaps of social functioning were calculated from a random sample of 550 severe mentally handicapped in 100 institutions and sheltered homes. The results of this cross-sectional study showed a high prevalence of diseases and handicaps, and a high mortality-rate until the age of 30, mainly determined by pre- and perinatal birth defects. The most healthy residents were found according to our criteria in the 30-50 year age group. A significant increase in health problems of ''the elderly'' were observed only after the age of about 50 years, as indicated by a high prevalence of diseases and sensory handicaps, mortality risk, motor problems and problems with basis personal skills. The linguistic skills of elderly persons were significantly better in comparison with the younger residents.

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