Prospective study on risk factors for falling in elderly persons with mild to moderate intellectual disabilities.
In elderly clients with mild–moderate ID, higher physical activity and better cognitive-motor skills actually raise fall risk—screen these ‘high-functioning’ individuals first.
01Research in Context
What this study did
Enkelaar et al. (2013) followed older adults with mild to moderate intellectual disability for one year.
They tracked who fell and measured activity level, attention, visuo-motor skill, and hyperactive traits.
The team wanted to see which traits, usually seen as strengths, might raise fall risk.
What they found
Almost half of the group fell at least once.
People with milder disability, higher activity, better attention, and better visuo-motor skill fell more often.
These ‘high-functioning’ traits explained over half of the fall risk.
How this fits with other research
Hsieh et al. (2012) and McConkey et al. (2010) found the opposite: seizures, arthritis, and walking aids predicted falls.
Those studies looked at obvious medical risks. Lotte’s team shows that fit, active clients hide a less visible risk.
Oppewal et al. (2014) later found that only past falls and lack of Down syndrome predicted future falls.
They did not find activity level useful, but they adjusted for many covariates, which can wash out weaker signals.
Kovačič et al. (2020) later built on Lotte’s profile and cut falls with balance-specific exercise, proving the risk can be lowered.
Why it matters
If your client with ID walks fast, joins games, and stays alert, do not assume they are safe. Screen these active clients first. Add balance drills and monitor environments just as closely as you would for clients with seizures or walkers.
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02At a glance
03Original abstract
Elderly persons with intellectual disabilities (ID) are at increased risk for falls and fall-related injuries. Although there has been extensive research on risk factors for falling in the general elderly population, research on this topic in persons with ID is rather sparse. This is the first study to prospective investigate risk factors for falling among elderly persons with mild to moderate ID. Seventy-eight ambulatory persons with mild to moderate ID (mean age 62.8 ± 7.6 years; 44 (56%) men; 34 (44%) mild ID) participated in this study. This longitudinal cohort study involved extensive baseline assessments, followed by a one-year follow-up on fall incidents. Falls occurred in 46% of the participants and the fall rate was 1.00 falls per person per year. The most important risk factors for falling in elderly persons with mild to moderate ID were (mild) severity of ID, (high) physical activity, (good) visuo-motor capacity, (good) attentional focus and (high) hyperactivity-impulsiveness, which together explained 56% of the fall risk. This pattern of risk factors identified suggests a complex interplay of personal and environmental factors in the aetiology of falls in elderly persons with ID. We recommend further research on the development of multifactorial screening procedures and individually tailored interventions to prevent falling in persons with ID.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.07.041