Adults with ID are at high risk for falls

By Kelly Hsieh, PhD
Rehabilitation Research and Training Center on Aging with Developmental Disabilities, University of Illinois at Chicago

Falls are a major health problem among older adults with intellectual disabilities (ID) living in community settings. Falls are also major causes of serious injuries and fractures in adults with ID. Large scale studies examining the prevalence rate of falls and the associated risk factors for adults with ID are very limited.

What did you do in your research?
The ongoing Longitudinal Health and Intellectual Disability Study collects data annually from the caregivers of adults with ID on health and function, health behaviors, and sociodemographic factors to examine the long term consequences of health behaviors and their impact on health outcomes in adults with ID. We examined information on falls from this data.

What did you find out?
  • One out of five adults with ID between 18-44 years old experienced at least one fall in the past year.
  • One out of three adults with ID between 45-64 years old experienced at least one fall in the past year which is comparable to that of the general elderly population (age 65 and older).
  • 43% of adults with ID age 65 and older experienced at least one fall in the past year.
  • 24% of those who experienced falls needed medical care.
  • Women are more likely to experience falls. After taking age into account, the fall rate was 43% higher for women than for men.
  • Being female, having arthritis, having a seizure disorder, having polypharmacy (taking more than four medications), using walking aids, and having difficulty lifting or carrying over 10 pounds were risk factors for falls.
  • For those who did not have a seizure disorder, having a higher level of ID, having arthritis, a heart condition, back pain, urinary incontinence, using a walking aid, and having difficulty walking 3 blocks were risk factors for falls.
  • For those who required medical care, having osteoporosis, back pain, and urinary incontinence were risk factors for falls.

What are the take-home messages?
  • Since adults with ID have a high rate of seizure disorder, it is critical to educate primary caregivers about the importance of monitoring seizures during the episodes to prevent occurrence of falls.
  • We identified the use of multiple medications as a risk factor for falls. For caregivers, carefully monitoring side effects of medications and consistently consulting with health care providers are crucial, especially to identify medicines that may cause side effects or interactions such as dizziness or drowsiness.
  • It is important to get screened and, if needed, treated for osteoporosis.
  • Adults with ID who have functional limitations (e.g., using walking aids, having difficulty lifting or carrying over 10 pounds, having difficulty walking 3 blocks) are at a higher risk for falling. It is important for them to exercise regularly and focus on increasing leg strength and improving balance.

To learn more about these findings contact
Kelly Hsieh or visit Project website.

Full Journal Article
Hsieh, K., Rimmer, J., and Heller, T. (2012). Prevalence of falls and risk factors in adults with intellectual disability. American Journal of Intellectual and Developmental Disabilities, 117(6), 442-454.