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Shriver Center studying falls prevention in people with intellectual, developmental disabilities

By Ellen Moran

UMass Medical School Communications

July 07, 2015

Adults of all ages with intellectual or developmental disabilities have the same risk of falling as people in the general population over age 65, but most programs to prevent falls have been designed for the elderly. The Eunice Kennedy Shriver Center at UMMS is studying whether a new program that uses customized care plans can reduce falls among people with disabilities.

The Shriver Center, a unit of UMass Medical School’s Commonwealth Medicine division, partnered with an outpatient rehabilitation provider, Visiting Rehab Services, to determine whether customizing care plans for individuals with intellectual and developmental disabilities will reduce their risk of falling.

“Research shows that people with intellectual disabilities have the same risk of falling as the elderly population, but experienced at much younger ages. Everyone agrees falls prevention is very important for this population,” said Courtney Dutra, MPA, a project coordinator at the Shriver Center.

Visiting Rehab Services implemented Upright and Onward, a falls prevention intervention targeted for individuals with intellectual and developmental disabilities who live in residential programs. The program used evidence-based falls prevention approaches for the elderly and tailored them for individuals with intellectual and developmental disabilities and those who support them.

The six-month pilot study includes 58 adults age 29 to 90 who live in residential homes supported by the Massachusetts Department of Developmental Services or private agencies.

The components of the pilot study include an assessment of an individual’s fall risk at baseline, three and six months; implementation and tracking of an individualized plan of care; and monitoring for falls with a weekly follow-up. The study was funded by the Agency for Healthcare Research and Quality, part of the U.S. Department of Health & Human Services.

Individuals with intellectual or developmental disabilities have a higher risk of falling than those who don’t have an intellectual disability, and they are more likely to be injured in a fall. Those who are taking multiple medications, have low muscle strength, poor balance or coordination, or vision issues could have a higher risk of falling. Existing falls prevention programs are typically designed for the elderly population, who also tend to have low muscle strength and poor balance and coordination.

“There is a cognitive piece to falls prevention programs for the elderly that might not be appropriate for this group,” Dutra said. “Degenerative changes seen in aging can also occur as early as age 35 in some individuals with ID, which further complicates falls intervention. Falls prevention in people with intellectual and developmental disabilities is a very understudied area.”

The goals of the pilot are to look at the feasibility of partnering with a community provider to study interventions in people with intellectual and developmental disability, the effect of the type and frequency of therapies provided in the customized care plan, and whether the individual’s falls risk changed, said Alexandra Bonardi, MHA, clinical assistant professor of family medicine & community health and project lead.