Osteoporosis in people with intellectual disabilities: a review and a brief study of risk factors for osteoporosis in a community sample of people with intellectual disabilities.
BACKGROUND
The population of people with intellectual disabilities (ID) is increasing and their health needs impact on primary and secondary healthcare specialities. One important aspect of their physical health is bone health as people with ID have increased risk factors associated with osteoporosis. It has been identified that this population has an increased prevalence of low bone mineral density (BMD), osteoporosis and osteopenia. The main contributory factors for low BMD are age, use of antiepileptics, immobility and diagnosis of Down's syndrome.


METHODS
A literature search of electronic databases was undertaken. Studies that included people with ID were reviewed for the prevalence of osteoporosis and osteopenia. A cross-sectional survey was conducted in a community sample (n = 149) to screen for risk factors for osteoporosis.


RESULTS
The majority of studies identified increased prevalence of osteoporosis and osteopenia with associated low BMD. In most studies individuals with ID presented with more than two risk factors. In our survey, we identified an increased prevalence of risk factors associated with osteoporosis, namely use of antiepileptics (64%), immobility (23%), history of falls (20%) and fractures (11%). We found that 54% of our sample fulfilled the criteria for screening. Of those who went on to have scans, 55% had osteoporosis and 33% had osteopenia.


CONCLUSIONS
We conclude that we should be screening for the risk factors associated with low BMD in adults with ID. If these are present further investigations should take place and those found to have osteoporosis and osteopenia should have treatment at an early stage to prevent morbidity and improve their quality of life.
Tees, Esk and Wear Valleys NHS Foundation Trust, Child and Adolescent Learning Disability psychiatry, Durham, UK. radha.srikanth@tewv.nhs.uk
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D000058:Accidental Falls / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000503:physiopathology; D005260:Female; D005598:Fractures, Spontaneous / Q000453:epidemiology / Q000209:etiology; D006306:Health Surveys; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D006113:United Kingdom; D055815:Young Adult
D000927:Anticonvulsants