1. A journal article from the American Association on Intellectual and Developmental Disabilities Presented by Dave Bertleff Youngstown State University

2.  Goal: To identify risk factors for falling in adults with intellectual disabilities.  Method: Use multinomial logistic regression to compare relationships between a non-metric dependent variable and metric or dichotomous independent variables.  Will compare groups through a combination of binary logistic regressions.

3.  The scale used to assess risk of fall in elderly persons with intellectual disabilities for this study and several others is called the Tinetti Instrument:  Balance test – 9 items (max score 16)  Gait test – 7 items (max score 12)

4.  25 was determined as cutoff point  Below = “Fallers”  Above = “Nonfallers”

5.  Data was then gathered from medical records regarding IQ, complicated conditions, and medications of the participants  Univariate analysis to determine ability to predict risk of fall  Then, variables with sig. levels <.05 entered into multivariate analysis

6. ParameterOdds Ratio95% CIX2X2 Gender (male)0.85 0.41-1.750.20 Age ≥ 50 years2.46 1.17-5.155.8* Epilepsy4.64 2.15-10.0216.42** Paretic conditions22.82 8.13-64.0949.40** Antipsychotics0.95 0.45-2.000.02 Anticonvulsants4.19 1.93-9.0714.03** After adjustment for the presence of epilepsy1.72 0.48-6.170.69 Benzodiazepines2.03 0.91-4.523.02 Antidepressants0.40 0.05-3.470.18 Level of intellectual disability: severe, or profound (IQ ≤ 34)1.87 0.59-5.941.14

7.  Stratification of the participants based on presence or absence of epilepsy eliminated impact of anticonvulsants on the risk of fall  Variables to be used in multivariate analysis:  Age  Epilepsy  Paretic conditions

8.  Multinomial Logistic Regression used with Faller/Nonfaller as the dependent variable  In SPSS, the “Factors” box is where the dichotomous variables, epilepsy and paretic conditions, are placed  The “Covariates” box is where the metric variable age is placed  Running the regression gave the following results…

9. ParameterOdds Ratio95% CIX2X2 Age1.061.01-1.116.02* Epilepsy6.552.33-18.3812.74** Paretic Condition 30.989.21-104.1630.80**  * p<.05  **p<.001

10.  All three are independent risk factors for falls in adults with intellectual disabilities  Data shows risk of fall increases by 1.06 n times over n years. (n=12 >> 2 times)  Presence of paretic conditions was most evident risk factor

11.  American Association on Intellectual and Developmental Disabilities  G. Rodriguez, Multinomial Response Models, Chapter 6