School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
J Intellect Disabil Res. 2019 Dec;63(12):1441-1452. doi: 10.1111/jir.12686. Epub 2019 Sep 9.
People with intellectual disability (ID) experience age-related changes earlier in life, and as such, falls among people with ID are of serious concern. Falls can cause injury and consequently reduce quality of life. Limited studies have investigated the incidence of falls among people with ID and the associated risk factors. The purpose of this study was to investigate the incidence of falls and risk factors for falling in people with ID living in the community.
A prospective observational cohort (n = 78) of community-dwelling adults with ID. Characteristics measured at baseline included falls history, medication use, balance and mobility. Falls were reported for 6 months using monthly calendars and phone calls. Data were analysed using univariate and multivariate logistic regression to identify risk factors associated with falling.
Participants [median (interquartile range) age 49 (43-60) years, female n = 32 (41%)] experienced 296 falls, with 36 (46.2%) participants having one or more falls. The incidence of falls was 5.7 falls (injurious falls = 0.8) per person year (one outlier removed from analysis). A history of falls [adjusted odds ratio (OR): 6.37, 95% confidence interval (CI) (1.90-21.34)] and being ambulant [adjusted OR: 4.50, 95% CI (1.15-17.67)] were associated with a significantly increased risk of falling. Falls were significantly less frequent among participants taking more than four medications [adjusted OR: 0.22, 95% CI (0.06-0.83)] and participants who were continent [adjusted OR: 0.25, 95% CI (0.07-0.91)].
People with ID fall at a younger age compared with the broader community. The associated falls risk factors also differ to older community-dwelling adults. Health professionals should prioritise assessment and management of falls risk in this population.
智力障碍（ID）患者的身体会较早出现与年龄相关的变化，因此，ID 患者的跌倒问题令人十分担忧。跌倒可能导致受伤，从而降低生活质量。已有研究调查了 ID 患者的跌倒发生率和相关的跌倒危险因素，但研究对象多为住院患者。本研究旨在调查社区居住的 ID 患者的跌倒发生率和跌倒危险因素。
前瞻性观察性队列研究（n=78），纳入社区居住的成年 ID 患者。基线时测量的特征包括跌倒史、用药情况、平衡和移动能力。使用每月日历和电话报告 6 个月内的跌倒情况。使用单变量和多变量逻辑回归分析来识别与跌倒相关的危险因素。
参与者（中位数[四分位间距]年龄 49[43-60]岁，女性 n=32[41%]）共发生 296 次跌倒，36（46.2%）名参与者发生过 1 次或多次跌倒。跌倒发生率为 5.7 次（受伤跌倒 0.8 次）/人年（1 名参与者数据异常，予以剔除）。有跌倒史（调整后的优势比[OR]：6.37，95%置信区间[CI]（1.90-21.34））和能走动（调整后的 OR：4.50，95% CI（1.15-17.67））与跌倒风险显著增加相关。服用 4 种以上药物（调整后的 OR：0.22，95% CI（0.06-0.83））和能自主控制大小便（调整后的 OR：0.25，95% CI（0.07-0.91））的参与者跌倒频率显著降低。
与普通社区人群相比，ID 患者的跌倒年龄更早。与年龄较大的社区居住成年人相比，ID 患者的跌倒相关危险因素也不同。卫生专业人员应优先评估和管理该人群的跌倒风险。
