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

Abstract

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.

Exploring enablers and barriers to accessing health services after a fall among people with intellectual disability

“…There were 36 participants who sustained one or more falls in the first phase of the research (Ho et al, ). Of all these falls, 13 falls were followed up with an interview with the 13 participants and/or their caregivers.…”

“…Adults with intellectual disability experience high rates of falls at an early age (Cox et al, ; Hsieh et al, ; Ho et al, ), and the most common cause for injuries in people with intellectual disability is falls (Finlayson, Morrison, Jackson, Mantry, & Cooper, ). Health professionals should therefore commence screening for older adults with intellectual disability for falls risk at a younger age compared to the general population.…”

“…Exercise, including balance components, has been shown to be effective in reducing falls in adults with intellectual disability (Crockett, Finlayson, Skelton, & Miller, ; Hale, Mirfin‐Veitch, & Treharne, ; Van Hanegem et al, ). Since adults with intellectual disability fall at rates that are higher than age‐matched populations (Enkelaar et al, ; Ho et al, ), it is important that they engage in specific exercises for falls prevention. However, participants reported very limited engagement in exercises of suitable intensity and mode.…”

“…This prevalence is higher than in the general community where falls increase at an older age and where 25%–35% of adults aged 65 years and older fall each year (Bloch et al, ; Milat et al, ). Identified risk factors for falls among people with intellectual disability include having a history of falls, seizures, challenging behaviours and higher levels of mobility (Cox, Clemson, Stancliffe, Durvasula, & Sherrington, ; Enkelaar, Smulders, van Schrojenstein Lantman‐de Valk, Weerdesteyn, & Geurts, ; Hsieh, Rimmer, & Heller, ; Ho et al, ), which are different to the general community (Ambrose, Paul, & Hausforff, ).…”

Effect of Lower Limb Muscle Fatigue on Fall Risk for Transfemoral Amputee: A Pilot Study

“…However, most of the risk factors associated with falls were based primarily on elderly patient cohorts and not on amputees. Other studies also include other factors such as age-related, intellectual disability, lower limb strength, and cerebrovascular disease that are related to falling risk [25][26][27]. Our cohort population for TFA is younger than previously studied with an age range of 20 to 45 years old.…”