Falls in older persons with intellectual disabilities: fall rate, circumstances and consequences

Smulders, Ellen; Enkelaar, L.; Weerdesteyn, Vivian; Geurts, A.C.H.; Valk, Henny van Schrojenstein Lantman-de

doi:10.1111/j.1365-2788.2012.01643.x

Cited by 39 publications

(72 citation statements)

References 43 publications

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“…Study designs vary, but our study most closely resembled a study conducted in the Netherlands (Smulders et al 2013). When these outliers were removed, the falls rate of 2.2 falls per person year is more closely aligned with the results from the study (Smulders et al 2013). This was inclusive of all participants including several who had a very high number of falls.…”

Section: Discussionsupporting

confidence: 68%

“…This was a higher falls rate compared with other studies conducted in people with ID. The study (Smulders et al 2013) collected falls prospectively from a similar population (older adults with ID ≥50 years old) for 12 months and had a falls rate of 1.0 fall per person year, while our observed falls rate was 8.2 falls per person year, eight times greater in 6 months. The study (Smulders et al 2013) collected falls prospectively from a similar population (older adults with ID ≥50 years old) for 12 months and had a falls rate of 1.0 fall per person year, while our observed falls rate was 8.2 falls per person year, eight times greater in 6 months.…”

Section: Discussionmentioning

confidence: 64%

“…Fall-related injuries include hip fracture and head injury (Australian Institute of Health and Welfare 2018). Some studies have reported that the prevalence of falls in adults with ID is over 40% (Smulders et al 2013), and the incidence of falls is over two falls per person year (Pal et al 2014;Van Hanegem et al 2014), which suggests that the prevalence and incidence of falls in older adults with ID are higher than age-matched populations and more aligned with falls rates among older adults. People with intellectual disability (ID) experience signs of aging from 35 years old (Connolly 1998) and as such can be considered 'older adults'.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and associated risk factors for falls in adults with intellectual disability

Bulsara

Patman

et al. 2019

J intellect Disabil Res

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Background People with intellectual disability (ID) experience age‐related changes earlier in life, and as such, falls among people with ID are of serious concern. Falls can cause injury and consequently reduce quality of life. Limited studies have investigated the incidence of falls among people with ID and the associated risk factors. The purpose of this study was to investigate the incidence of falls and risk factors for falling in people with ID living in the community. Methods A prospective observational cohort (n = 78) of community‐dwelling adults with ID. Characteristics measured at baseline included falls history, medication use, balance and mobility. Falls were reported for 6 months using monthly calendars and phone calls. Data were analysed using univariate and multivariate logistic regression to identify risk factors associated with falling. Results Participants [median (interquartile range) age 49 (43–60) years, female n = 32 (41%)] experienced 296 falls, with 36 (46.2%) participants having one or more falls. The incidence of falls was 5.7 falls (injurious falls = 0.8) per person year (one outlier removed from analysis). A history of falls [adjusted odds ratio (OR): 6.37, 95% confidence interval (CI) (1.90–21.34)] and being ambulant [adjusted OR: 4.50, 95% CI (1.15–17.67)] were associated with a significantly increased risk of falling. Falls were significantly less frequent among participants taking more than four medications [adjusted OR: 0.22, 95% CI (0.06–0.83)] and participants who were continent [adjusted OR: 0.25, 95% CI (0.07–0.91)]. Conclusions People with ID fall at a younger age compared with the broader community. The associated falls risk factors also differ to older community‐dwelling adults. Health professionals should prioritise assessment and management of falls risk in this population.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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Incidence and associated risk factors for falls in adults with intellectual disability

Bulsara

Patman

et al. 2019

J intellect Disabil Res

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“…In this study, changes were generally greater for the younger group of participants <50 years, suggesting that reduction of fall risk can occur at an earlier age among adults with IDD, which is important considering these individuals age at and experience falls risk at different rates of those without IDD (6, 7, 61). These results suggest that early initiation of programing to reduce the risk of falls in both groups is a beneficial idea.…”

Section: Discussionmentioning

confidence: 66%

“…Adults with IDD experience a higher rate of falls (6) relative to their peers who are community-dwelling and cognitively intact. Smulders et al determined that the fall rate in this population was approximately threefold higher than their non-disabled peers (6). Although the fall circumstances and outcomes were similar, the falls rate among individuals with IDD was far higher.…”

Section: Introductionmentioning

confidence: 99%

Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program

Renfro

Bainbridge

Smith

2016

Front. Public Health

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IntroductionEvidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer’s disease and related dementias, cerebral vascular accident, or traumatic brain injury.BackgroundAdults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention.MethodsA modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment.ResultsDespite the limited number of participants (n = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period.DiscussionPromising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more participants in diverse geographic regions with longer lengths of participation and follow-up.

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Fracture risk in people with developmental disabilities: results of a large claims data analysis

et al. 2016

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Falls in older persons with intellectual disabilities: fall rate, circumstances and consequences

Abstract: The circumstances and consequences of falls in persons with ID are comparable to those of the general elderly population, but the rate is substantially higher. As such, appropriate fall prevention strategies must be developed for individuals with ID.

Cited by 39 publications

References 43 publications

Incidence and associated risk factors for falls in adults with intellectual disability

Incidence and associated risk factors for falls in adults with intellectual disability

Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program

Fracture risk in people with developmental disabilities: results of a large claims data analysis

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