New Study Calls for Age-Friendly Health Systems to Include Adults with Disabilities
The National Task Group on Intellectual Disabilities and Dementia Practices (NTG)
The National Task Group on Intellectual Disabilities and Dementia Practices (NTG) is pleased to spotlight a newly published article co-authored by NTG Board Member Dr. Teresa Moro of Rush University Medical Center, titled “From the 4Ms to a Disability-Friendly Healthcare System.” The piece appears in The Gerontologist, the flagship peer-reviewed journal of the Gerontological Society of America and offers a powerful critique of the age-limited framework currently guiding much of U.S. health system reform.
Co-written with colleagues, Dr. Jacqueline McGinley and Bonnie Ewald, from the College of Health Sciences at Rush University, the article explores the potential of expanding the widely implemented Age-Friendly Health Systems (AFHS) 4Ms framework to include adults with disabilities, especially those with intellectual and developmental disabilities.
Dr. Teresa Moro of Rush University Medical Center
There are approximately 3,922 Age-Friendly Health Systems in the United States. These systems aim to improve healthcare for older adults (65+) by ensuring that care delivery aligns with the 4Ms: (1) what matters, (2) medication, (3) mentation, and (4) mobility. However, Dr. Moro and her co-authors point out that no equivalent system exists to guide high-quality care for adults with disabilities, even though many experience aging-related health and cognitive conditions decades earlier than the general population.
“In the U.S., Age-Friendly Health Systems promote better care by routinely incorporating the 4Ms into patient interactions,” the authors write. “But by focusing solely on adults over age 65, we are missing an opportunity to improve the health and well-being of people with disabilities.”
“NTG Board Member Dr. Teresa Moro and colleagues published an article in The Gerontologist advocating for equitable healthcare for younger adults with disabilities.”
For instance, adults with Down syndrome are significantly more likely to develop early-onset Alzheimer’s disease, often in their fifties or earlier. Many others with developmental disabilities face premature aging, higher rates of chronic disease, and inadequate care coordination—factors that mirror the challenges AFHS was designed to address. The article posits that implementing the 4Ms framework with younger adults with disabilities could promote more person-centered, equitable care, while also advancing compliance with the Americans with Disabilities Act (ADA). “Applying a proven model like the 4Ms earlier in life can improve quality of care, strengthen communication, and address disparities,” said Dr. Moro.
The authors argue that integrating the 4Ms into disability care could create a “disability-friendly health system” that better meets the needs of a growing and diverse population. It also positions health systems to take meaningful steps toward equity—especially as life expectancy for people with IDD continues to rise.
The article has immediate implications for health professionals, policy makers, and system leaders seeking to advance health equity for people with disabilities. It also aligns with the NTG’s broader mission to enhance supports for adults with intellectual disability and dementia and promote inclusion within mainstream aging and healthcare systems.
Read the full article in The Gerontologist: “From the 4Ms to a Disability-Friendly Healthcare System” by Teresa Moro, PhD, et al at https://doi.org/10.1093/geront/gnaf060.
Dr. Moro is an Assistant Professor in the Department of Social Work in the College of Health Sciences at RUSH University Medical Center in Chicago. Currently, Dr. Moro is a PI on two pilot awards titled 'Social Workers and Community Health Workers in Primary Care: A RE-AIM Impact Study' and 'Person-centered Psychotherapy Outcomes Measurement: Partnering with Patients and Therapists to Design a Value-driven Process', and a Co-I on the Partnering with Persons with Intellectual and Developmental Disabilities to Transform Health Outcomes (PATH-PWIDD) Program. Dr. Moro is interested in providing high-quality social and healthcare management to older adults with intellectual and developmental disabilities.
For more information about the NTG or Dr. Moro’s work, visit www.the-ntg.org