Interventions to reduce falls in community-dwelling adults with intellectual disability: a systematic review.
Only seven small studies exist on falls-prevention for adults with ID, so evidence is too thin to guide practice yet.
01Research in Context
What this study did
Waldron et al. (2023) hunted for every paper that tested ways to stop falls in adults with intellectual disability. They found only seven small studies. Most used exercise classes or visits to a falls clinic.
The team graded the quality of each study. All were weak. None had big samples or strong controls.
What they found
Exercise or clinic visits seemed to cut falls, but the proof is thin. The authors cannot say which method works best.
Because the evidence is so small, they urge clinicians to treat the results as hints, not rules.
How this fits with other research
Doughty et al. (2010) faced the same problem. Their review of abuse-protection skills also found only eight small studies for adults with ID. Both papers show that basic safety research in this population is still in its infancy.
Oliveira et al. (2014) reviewed exercise for people with spina bifida and reached a near-identical conclusion: training helps, but evidence quality is low. The pattern repeats across diagnoses.
Taken together, these reviews signal a gap: adults with ID are living in the community, yet we lack solid trials to keep them safe and healthy there.
Why it matters
If you support community-dwelling adults with ID, you now know the falls-prevention playbook is mostly blank. Use extra safety checks during home visits. Start low-impact exercise groups if physician clears, but monitor closely and document outcomes. Your data could become the evidence we still need.
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02At a glance
03Original abstract
BACKGROUND: People with intellectual disability have a high risk of falls and falls-related injuries. Although people with intellectual disability are at increased risk of falls, there is a need to better understand the efficacy of interventions that can help reduce falls and address risk factors in this population. This systematic review aimed to evaluate the type, nature and effectiveness of interventions undertaken to reduce falls with community-dwelling adults with intellectual disability and the quality of this evidence. METHOD: Four electronic databases were searched: Ovid MEDLINE, PsycINFO, CINAHL Plus and the Cochrane Library. Studies were included if they involved people aged 18 years or over, at least 50% of study participants had intellectual disability, participants were community-dwelling, and the study evaluated any interventions aiming to reduce falls. Study quality was assessed using the National Institutes of Health study quality assessment tools. Reporting of the review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Seven studies were eligible for review, with a total of 286 participants and mean age of 50.4 years. As only one randomised trial was identified, a narrative synthesis of results was undertaken. Five studies evaluated exercise interventions, one evaluated a falls clinic programme, and one evaluated stretch fabric splinting garments. Methodological quality varied (two studies rated as good, four as fair, and one as poor). Exercise interventions varied in terms of exercise type and dosage, frequency and intensity, and most did not align with recommendations for successful falls prevention exercise interventions reported for older people. While the majority of studies reported reduced falls, they differed in methods of reporting falls, and most did not utilise statistical analyses to evaluate outcomes. CONCLUSION: This review identified a small number of falls prevention intervention studies for people with intellectual disability. Although several studies reported improvements in fall outcomes, ability to draw conclusions about intervention effectiveness is limited by small sample sizes and few studies. Further large-scale research is required to implement and evaluate falls prevention interventions specifically for adults with intellectual disability.
Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13066