Assessment & Research

The association between medication use and gait in adults with intellectual disabilities.

Maas et al. (2020) · Journal of intellectual disability research : JIDR 2020
★ The Verdict

Multiple meds make adults with ID walk less safely—screen gait yearly and push for deprescribing.

✓ Read this if BCBAs serving adults with ID in day programs or group homes.
✗ Skip if Clinicians working only with med-free children.

01Research in Context

01

What this study did

Researchers watched the adults with intellectual disability walk.

They counted how many meds each person took.

Then they linked drug load to tiny changes in step length and balance.

02

What they found

People on three or more drugs took shorter steps.

They kept both feet on the ground longer between steps.

This cautious style raises fall risk, even when the drugs help mood or behavior.

03

How this fits with other research

Arwert et al. (2020) also saw odd gait in adults with autism.

But they blamed the diagnosis itself, not the drugs.

The new study shows meds can create similar patterns in adults with ID.

MacRae et al. (2015) and Jackson et al. (2025) warn that adults with ID often hide diabetes.

Tight gait screening now joins blood-sugar checks in yearly health visits.

04

Why it matters

If your client with ID takes multiple meds, watch them walk.

Shuffling steps or wide stance can signal higher fall risk.

Share the video with the doctor and ask if any drug can be reduced or switched.

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Film each client walking 10 steps and note step length—flag anyone with short, shuffling steps for medical review.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
31
Population
intellectual disability
Finding
negative
Magnitude
small

03Original abstract

BACKGROUND: Adults with intellectual disabilities (ID) often have polypharmacy and often use antipsychotics. Both polypharmacy and antipsychotics have a negative effect on gait in the general population, but this has not been studied in adults with ID. These negative effects may add to pre-existing gait disturbances in adults with ID and increase the risk for adverse health outcomes in this population. Therefore, the aim of this study is to investigate the difference in gait parameters between adults with ID with and without polypharmacy and between adults with ID using and not using antipsychotics. METHOD: The gait parameters of 31 participants were collected with the GAITRite walkway, a pressure sensitive walkway measuring spatial and temporal gait parameters, in addition to information about personal characteristics, prescribed medication and presence of polypharmacy. RESULTS: After adjustment for sex and body mass index, participants with polypharmacy had a significantly shorter step length [polypharmacy B (SE) = -0.079 (0.034), P = 0.03], shorter stride length [polypharmacy B (SE) = -0.157 (0.069), P = 0.03] and longer double support time [polypharmacy B (SE) = 0.0004 (0.0001), P = 0.047]. Participants using antipsychotics had a significantly longer double support time [antipsychotic use B (SE) = 0.0003 (0.0002), P = 0.019]. CONCLUSION: This study showed for the first time that both polypharmacy and using antipsychotics are associated with gait in adults with ID. The differences seem to resemble a more cautious gait. Further investigation with larger study samples, additional medication types and dosages are needed to acquire more insight in this important topic.

Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12773