[Aging with intellectual and developmental disabilities or severe multiple disabilities-health, participation, and care in later life].

Over the past decades, life expectancy in Germany has steadily increased. This trend also applies to people with physical, intellectual, and multiple disabilities, although their life expectancy remains at a significantly lower level. Compared with the general population, differences are evident in health, social participation, and quality of life. Multimorbidity, chronic diseases, and frailty occur earlier and more frequently in people with intellectual disabilities and severe multiple disabilities, leading to limitations in daily life and increased care needs. For some individuals with intellectual and developmental disabilities (IDD), disability-specific risk factors also play a role, such as a higher prevalence of epilepsy and mental health disorders, or, in the case of Down syndrome, the early onset of dementia.In addition to medical challenges, psychosocial factors become increasingly important in later life, including loneliness, inadequate social participation, and grief over the loss of previously mastered abilities. Despite improvements in care, the average life expectancy of people with severe intellectual and developmental disabilities and severe multiple disabilities remains substantially reduced. Like most people, they generally wish to grow old and die in familiar surroundings. However, due to inadequate support and care services, many are often forced to accept an unwanted move to a residential nursing home for older adults.This review article discusses epidemiological data, the specific challenges faced by ageing people with intellectual and developmental disabilities, and the practical implications for improving care and social participation.