Prevention of falls for adults with intellectual disability (PROFAID): a feasibility study

Hale, Leigh; Mirfin‐Veitch, Brigit; Treharne, Gareth J.

doi:10.3109/09638288.2015.1017613

Cited by 16 publications

(29 citation statements)

References 31 publications

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“…This highlights the complexity of falls and fall-risk factors among older people with ID. Nevertheless, among people with ID, as in the general population, falls may be prevented by exercises and physical activity [ 40 , 41 ]. Thus, in addition to medication reviews, physiotherapy interventions are relevant among older people with ID in order to reduce falls.…”

Section: Discussionmentioning

confidence: 99%

Fall-risk-increasing drugs and falls requiring health care among older people with intellectual disability in comparison with the general population: A register study

et al. 2018

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BackgroundFalls are the most common cause of injury for older people in the general population as well as among those with intellectual disability. There are many risk factors for falls, including a range of drugs which are considered to be fall-risk-increasing (FRIDs). The aim of the present study was to describe prescription patterns of FRIDs in itself as well as in relation to falls requiring health care among older people with intellectual disability and their age-peers in the general population. Moreover, to investigate possible differences between the two groups.MethodsA cohort of people with intellectual disability and a referent cohort, one-to-one-matched by sex and year of birth, were established. Each cohort comprised 7936 people aged 55+ years at the end of 2012. Register data were collected for 2006–2012 on prescription of antidepressants, anxiolytics, hypnotics and sedatives, opioids, and antipsychotics, as well as for fall-related health care contacts. Analyses were performed on yearly data, using repeated measures models.ResultsPeople with intellectual disability were more likely to be prescribed at least one FRID (Relative Risk [RR] 2.31). The increase was highest for antipsychotics (RR 25.0), followed by anxiolytics (RR 4.18), antidepressants (RR 2.72), and hypnotics and sedatives (RR 1.42). For opioids, however, a lower prevalence (RR 0.74) was found. In both cohorts, those with prescription of at least one FRID were more likely to have a fall-related injury that required health care. The increased risk was higher in the referent cohort (RR 3.98) than among people with intellectual disability (RR 2.27), although people with intellectual disability and prescription still had a higher risk of falls than those with prescription in the referent cohort (RR 1.27). A similar pattern was found for all drug groups, except for opioids, where prescription carried the same risk of having a fall-related injury that required health care in both cohorts.ConclusionsWith or without prescription of FRIDs, older people with ID have a higher risk of falls requiring health care than their age-peers in the general population. It is important to be aware of this when prescribing drugs that further increase the risk of falls.

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Section: Discussionmentioning

confidence: 99%

Fall-risk-increasing drugs and falls requiring health care among older people with intellectual disability in comparison with the general population: A register study

et al. 2018

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“…In addition, easily accessible training modules were necessary to close the gap between knowledge and dissemination (24). The selected EBFP would be easily adaptable to wide variations in physical and cognitive functioning and include exercise for lower extremity strength and standing balance, both known to improve fall risk for the population (25). We placed a heavier emphasis on physical activity than on education because educational components might present difficulties to translation and teaching for this population.…”

Section: Background and Rationalementioning

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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“…; Hale et al . ) and regular drug reviews. A range of fall risk assessment tools has been found suitable for use among people with ID (Waninge et al .…”

Section: Discussionmentioning

confidence: 99%

“…They are more likely to have medical conditions known to affect fall risk, such as epilepsy (Lukaszyk et al 2016;Cooper et al 2017), diabetes mellitus (Vinik et al 2017) and dementia Meuleners and Hobday 2017), as well as to 200 be prescribed drugs known to increase the risk of falls, such as antidepressants, anxiolytics and hypnotics (Enderlin et al 2015). Thus, potential ways of decreasing the prevalence of falls among older people with ID may be physical activity and physiotherapeutic interventions (Bartlo & Klein 2011;Van Hanegem et al 2014;Hale et al 2016) and regular drug reviews. A range of fall risk assessment tools has been found suitable for use among people with ID (Waninge et al 2011a;Waninge et al 2011b;Hilgenkamp et al 2012;Enkelaar et al 2013b;Salb et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Falls resulting in health care among older people with intellectual disability in comparison with the general population

Axmon

Ahlström

Sandberg

2018

J intellect Disabil Res

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Background Falls are common among older people with intellectual disability (ID) and are also a major contributor to injuries in this population. Yet, fall characteristics have only been sparsely studied, and the results are inconsistent. The aim of the present study was to investigate type of falls, places where they occurred and activities that caused them, as well as health outcomes and health utilisation patterns after falls, among older people with ID in comparison with their age peers in the general population. Methods We established an administrative cohort of people with ID aged 55 years, or more, and alive at the end of 2012 (ID cohort; n = 7936). A cohort from the general population, one‐to‐one matched by sex and year of birth, was used as referents. Data regarding fall‐induced health care episodes in inpatient and outpatient specialist care were collected from the National Patient Register for the period 2002–2012. Results With the exception of falls from one level to another (i.e. fall on and from stairs and steps, ladder and scaffolding; fall from, out of or through building or structure; fall from tree or cliff and diving or jumping into water; or other fall from one level to another), people in the ID cohort were more likely to fall and fall more often than those in the general population cohort. Falls during a vital activity (e.g. attending to personal hygiene or eating) were twice as common among people with ID compared with the general population. When falling, people with ID were more likely to injure their head and legs but less likely to sustain injuries to the thorax and elbow/forearm. They were more likely to have superficial injuries, open wounds and fractures but less likely to have dislocations, sprain and strains. Fall‐related health care visits among people with ID were more likely to be in inpatient care and be unplanned. People with ID were also more likely than those in the general population to have a readmission within 30 days. Conclusions People with ID are more likely to require specialist care after a fall and also more likely to obtain injuries to the head, compared with the general population. This is important to consider when taking preventive measures to reduce falls and fall‐related injuries.

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Prevention of falls for adults with intellectual disability (PROFAID): a feasibility study

Cited by 16 publications

References 31 publications

Fall-risk-increasing drugs and falls requiring health care among older people with intellectual disability in comparison with the general population: A register study

Fall-risk-increasing drugs and falls requiring health care among older people with intellectual disability in comparison with the general population: A register study

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

Falls resulting in health care among older people with intellectual disability in comparison with the general population

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