title: A study of bone mineral density in adults with disability.
abstract: OBJECTIVE
  To examine prevalence of low bone mineral density (BMD) among adults with disability, using World Health Organization diagnostic categories.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  National Rehabilitation Hospital, Dublin, Ireland.
  
  
  METHODS
  Patients (N=255; 178 men, 77 women) who were disabled for at least 3 months because of acquired brain injury, spinal cord injury, other neurologic condition, or lower-limb amputation.
  
  
  METHODS
  None.
  
  
  METHODS
  Laboratory investigations including intact parathyroid hormone, 25-hydroxyvitamin D (25-OHD), and sex hormones; and BMD of lumbar spine and at least 1 hip, measured by dual-energy x-ray absorptiometry and expressed as T scores and z scores.
  
  
  RESULTS
  Mean age +/- SD of participants was 48.7+/-15.6 years. Vitamin D deficiency, 25-OHD level 50 nmol/L or less, occurred in 154 (62.9%); insufficiency, a level between 51 and 72 nmol/L, occurred in 36 (14.7%). Based on T scores, 108 participants (42.4%) had osteopenia, and 60 (23.5%) had osteoporosis. A z score of -1 or less but more than -2 occurred in 76 (29.8%); a further 52 (20.4%) had a z score of -2 or less. On multiple linear regression analysis, ambulatory status and duration of disability were independent predictors of BMD at neck of femur (beta=.152, P=.007; beta=-.191, P=.001, respectively) and total proximal femur (beta=.170, P=.001; beta=-.216, P<.001, respectively).
  
  
  CONCLUSIONS
  Osteopenia and osteoporosis are very common in adults with disability participating in rehabilitation, compared with the general young adult population. Duration since onset of disability and mobility status are independent predictors of BMD at the hip. Bone health monitoring should form part of the long-term follow-up in adults with newly acquired disabilities.
authors: Department of Rehabilitation Medicine, National Rehabilitation Hospital, Dublin, Ireland. eimear.smith@nrh.ie
authors: Eimear M
authors: EM
authors: Smith
authors: Catherine M
authors: CM
authors: Comiskey
authors: Aine M
authors: AM
authors: Carroll
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000503:physiopathology; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012959:Socioeconomic Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: D012739:Gonadal Steroid Hormones; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D