Falls in older persons with intellectual disabilities: fall rate, circumstances and consequences.
Older adults with ID fall once a year and one in nine hits is severe—screen balance and hazards today.
01Research in Context
What this study did
Robertson et al. (2013) watched older adults with intellectual disability for one year. Staff wrote down every fall, where it happened, and how badly the person was hurt.
No one tried to stop the falls; the team just counted them.
What they found
Each person fell once a year on average. One in every nine falls caused a severe injury like a broken bone or head wound.
Most falls happened indoors while walking or changing position, the same spots that trip up typical seniors.
How this fits with other research
Oppewal et al. (2013) tested the Berg Balance Scale in the same 2013 year and group. They found balance scores 20 years below age norms, giving you a quick screen for the very people E et al. say will fall.
Dijkhuizen et al. (2017) later showed the Berg Balance Scale fails to predict falls once visual disability is added. The tool still works for pure ID; it just stumbles when eyesight is poor.
Mount et al. (2011) had already flagged falls as a red flag for osteoporosis in adults with ID. E et al. now give the hard numbers that justify adding bone checks after any fall.
Why it matters
You now have a one-minute balance test and a one-line rule: every older adult with ID falls once a year and has an 11% chance of serious injury. Add the Berg Balance Scale to annual plans, remove throw rugs, and refer for bone density after the first tumble.
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02At a glance
03Original abstract
BACKGROUND: Falling is a common cause of injuries and reduced quality of life. Persons with intellectual disabilities (ID) are at increased risk for falls and related injuries. As the number of elderly persons with ID is growing rapidly, it is imperative to gain insight into the quantity of the problem of falling, the circumstances that precipitate falls and to better understand their aetiology in persons with ID. This is the first study to prospectively investigate fall rate, circumstances and fall consequences in older adults with mild to moderate ID. METHOD: Eighty-two individuals with mild to moderate ID, 50 years and over [mean age 62.3 (SD = 7.6), 34 male], participated in this study, which was conducted at three service providers for persons with ID in the Netherlands. Falls were registered for 1 year with monthly fall registration calendars to determine the fall rate (mean number of falls per person per year). Information on fall circumstances and consequences was obtained from questionnaires completed by caregivers and study participants after each fall. RESULTS: We determined that the fall rate in this sample was 1.00 fall per person per year. Thirty-seven participants reported at least one fall (range 1-6). Sex and age were not related to falls. Most falls occurred while walking (63.3%), outside (61.7%) and in familiar environments (88.9%). Importantly, 11.5% of falls resulted in severe injuries, approximately half of which were fractures. CONCLUSION: 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.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01643.x