Injuries and falls among adults with intellectual disability: A prospective New Zealand cohort study

Background: Falls and fall-related injuries are a problem for many adults with intellectual disability. Most previous studies have collected falls data retrospectively, using organisational incident reports. We developed tools to specifically collect fall-related data and potential fall risk data. This paper reports on the development of these tools and the fall-related data collected in 3 prospective studies. Method: Consultations with 33 stakeholders representing 29 organisations and 5 focus group discussions were used to develop 2 tools for gathering information. Studies in 3 cities applied the tools to explore their acceptability, utility, and cultural appropriateness. Results: Two simple tick box forms were developed; both were easy and quick to complete. In the studies, 135 individuals participated (70 males, 65 females, aged 45 [SD = 11] years), of whom 27% experienced a fall; 39% of these resulted in an injury. Injuries were mostly bruises (30%) and grazes (28%), particularly to the facial area (42%). The 6-month period prevalence of falls was 0.76%. Most falls occurred indoors and during the daytime. Individuals appeared more likely to experience a fall if they had had previous falls and/or fractures, epilepsy, orthopaedic-related conditions, and problems with gait and balance. Conclusion: A robust process ensured the acceptability, utility, face and content validity, and cultural safety of our data collection tools. Falling is a serious problem for many people with intellectual disability, but the reasons for falling appear multifaceted and complex, complicating the development of fall prevention programs.