Identification and prediction of fall risk in mentally retarded elderly people

It is commonly known that mentally disabled are at higher risk for falls and
fall-related injuries than their mentally healthy counterparts. The fall risk
increases with age and peaks in the geriatric population. Prospective studies
on fall risk factors in the population of the older mentally disabled are not
available yet. This knowledge, however, is a prerequisite for the development
of targeted intervention strategies. In the general population of elderly, risk
factors for falls have been well-documented: mobility impairments (balance,
gait, strength), the use of psychotropic drugs, impaired vision, and cognitive
and behavioral impairments play an important role. It is largely on these
domains that disease-specific deficits are present in the mentally disabled. It
can therefore be expected that risk factors for falls in the older mentally
disabled are similar to those in the general population of elderly, but that
their relative contribution differs. In addition, the possibilities for
treatment or prevention may also be quite different.

Primary objective:
To determine the most important risk factors for falls in elderly people with
mental retardation and to describe which of these factors may be modified by
intervention/treatment, in order to prevent falls.
Secondary objective:
To determine whether balance and gait skills, as measured by clinical tests,
show deficits in mentally retarded elderly when compared to a reference group
of mentally healthy controls.
To identify the role of changes in balance and gait correcting responses in the
risk of falls in mentally retarded elderly.

In the proposed project, extensive assessments will be conducted on the various
domains of (potential) fall risk factors in a total of 100 older mentally
disabled, especially on the domain of motor skills, sensory qualities, and
cognitive and behavioral functioning. In addition, patient files will be
screened for other fall risk factors, such as the use of psychotropic drugs and
the presence of comorbidities. During a follow-up period of 2 years, fall
incidents in these participants will be monitored prospectively. In subgroups
of participants additional instrumented assessments of complex balance and gait
skills will be conducted, as well. The results will be compared to the
perfomance of mentally healthy age-matched controls. In addition, within the
group of mentally retarded elderly, the performance of non-fallers will be
compared to the performance of recurrent fallers.

N.A.