Falls resulting in health care among older people with intellectual disability in comparison with the general population.
A Axmon, G Ahlström, M Sandberg
PMID 30407691WHAT IT FOUND
Older people with intellectual disability had more fall-related health care contacts than matched peers, especially at institutions and during daily activities like eating or hygiene.
They sustained more head, hip, and leg injuries, required longer hospital stays, and were readmitted more often.
Key findings
01People with intellectual disability had a higher relative risk of any fall-related health care contact compared to the general population (RR 1.79), with particularly high risks for falls involving furniture or equipment (RR 6.44) and falls in institutions (RR 13.8).
02When falling, people with intellectual disability were more likely to injure their head, hip/thigh, and knee/lower leg, and more likely to sustain fractures, open wounds, and superficial injuries than the general population.
03Fall-related injuries in the intellectual disability cohort led to more inpatient care, longer hospital stays, and higher rates of readmission within 30 days compared to the general population.
STILL TO COME
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What it does not show
The study used receipt of LSS support as a proxy for ID, which may have included some individuals with Autism Spectrum Disorder (ASD) without ID, though the authors state this impact was minor. Health care data only covered inpatient and outpatient specialist care, excluding primary care visits. This means the results reflect severe falls or those requiring specialist attention, potentially missing minor falls. The difference in health care utilization may reflect differences in care-seeking behavior or staff decision-making in institutions, rather than just injury severity. The 'older' age cut-off was 55 years, reflecting earlier aging in ID, but this makes direct comparison to general population norms (usually 65+) complex, though matched controls were used.
Declared interests
The authors declare no conflicts of interest. The study was supported by non-U.S. government funding.
The easy way to misread this
Do not assume these findings apply to all falls in people with ID. The study only captured falls that resulted in health care contacts (inpatient or specialist outpatient), so it overrepresents severe injuries and underrepresents minor falls that were managed in primary care or by staff without a medical visit.