Post on 13-Feb-2016
description
A journal article from the American Association on
Intellectual and Developmental Disabilities
Presented by Dave BertleffYoungstown State University
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.
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)
25 was determined as cutoff point
Below = “Fallers”
Above = “Nonfallers”
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
Parameter Odds Ratio 95% CI X2
Gender (male) 0.85 0.41-1.75 0.20Age ≥ 50 years 2.46 1.17-5.15 5.8*Epilepsy 4.64 2.15-10.02 16.42**Paretic conditions 22.82 8.13-64.09 49.40**Antipsychotics 0.95 0.45-2.00 0.02Anticonvulsants 4.19 1.93-9.07 14.03** After adjustment for the presence of epilepsy 1.72 0.48-6.17 0.69Benzodiazepines 2.03 0.91-4.52 3.02Antidepressants 0.40 0.05-3.47 0.18Level of intellectual disability: severe, or profound (IQ ≤ 34)
1.87 0.59-5.94 1.14
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
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…
Parameter
Odds Ratio
95% CI X2
Age 1.06 1.01-1.11 6.02*Epilepsy 6.55 2.33-18.38 12.74**
Paretic Condition
30.98 9.21-104.16
30.80**
* p<.05 **p<.001
All three are independent risk factors for falls in adults with intellectual disabilities
Data shows risk of fall increases by 1.06n times over n years. (n=12 >> 2 times)
Presence of paretic conditions was most evident risk factor
American Association on Intellectual and Developmental Disabilities
G. Rodriguez, Multinomial Response Models, Chapter 6