Review of risk factors and preventative strategies for fall-related injuries in people with intellectual disabilities.

ABSTRACT

AIMS: To explore the risk factors and management of falls in people with intellectual disabilities and develop evidence-based recommendations. BACKGROUND: Falling is a common cause of physical injury and impaired quality of life in people with intellectual disability. Risk factors for falls and falls prevention have been extensively researched in the general population but there is a paucity of evidence specific to people with intellectual disabilities. DESIGN: Systematic review and comment. METHOD: Publications on the prevalence, risk factors and prevention of falls in people with intellectual disability were sought. We searched MEDLINE, CINAHL, PsychInfo and AMED (1 January 2000-7 January 2009). Search terms used to extract the relevant articles were 'intellectual disability', 'falls', 'injury', 'fractures', 'risk factors' and 'prevention'. RESULTS: Seven articles met the inclusion criteria. Up to 57% of people with intellectual disabilities experienced a fall. Falling was the cause of 50-62% of all recorded injuries. Risk factors for falls in people with intellectual disabilities may include older age, impaired mobility, epilepsy and behavioural problems. There was a paucity of evidence for intervention strategies identified. CONCLUSION: There is a lack of evidence for falls management in people with intellectual disabilities. Findings suggest that falls are a common cause of injury, institutionalisation and impaired quality of life in people with intellectual disabilities. Environmental safety, careful medical management and exercise interventions may play an important role in minimising fall-related injuries. Further research is needed to explore risk factors for falls and falls management in this vulnerable group. RELEVANCE TO CLINICAL PRACTICE Early identification of the risk factors and prevention of falls will inform nurses and other healthcare professionals those who are at most risk and how to minimise injury in people with an intellectual disability. A multi-model approach of comprehensive assessment and tailored intervention are worthy of endeavour.