title: Low bone mineral density among adults with disabilities in Taiwan: A cross-sectional descriptive study.
abstract: BACKGROUND
  Low bone mineral density (BMD) is a silent disease that can lead to osteoporosis and is a serious health problem worldwide. People with disabilities are especially at risk for fall-related death.
  
  
  OBJECTIVE
  To examine the prevalence of low bone mineral density and associated risk factors among adults with disabilities in Taiwan.
  
  
  METHODS
  We conducted a population-based, cross-sectional study in 2013; the participants were 572 community adults with disabilities over the age of 20 years. Statistical analyses used to evaluate the association included chi-squared tests, ANOVA, and logistic regression.
  
  
  RESULTS
  Over one-third of the participants had an intellectual disability, 26% physical disability, and the remainder had a combination of disabilities. Of the participants, 62.5% had abnormal bone mineral density, and 21.8% met the criteria for osteoporosis. After adjusting for potential confounding variables, the determinant risk factors for low bone mineral density were age (β = -.14, p = 0.002), gender (β = -.12, p = 0.004), and level of physical activity (β = .1, p = 0.024). The majority of participants with low BMD were not aware of abnormal bone density, and only 2.4% had received treatment.
  
  
  CONCLUSIONS
  This study identified a high prevalence of low bone mineral density among adults with disabilities; few of the participants possessed awareness of bone health, and very few received early treatment or information on prevention of osteoporosis. The enhancement of osteoporosis interventions and health promotion programs to prevent osteoporosis and related problems are necessary for this population.
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Yunlin, Taiwan.
authors.forename: Po-Han
authors.initials: PH
authors.lastname: Chen
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology, Taiwan.
authors.forename: Chu-Yeh
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Department of Health Promotion, Chiayi Bureau of Health, Taiwan.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Lin
authors.affiliation: College of Nursing, Chang Gung University of Science and Technology, No. 2, Chiapu Rd., West Sec., Puzi City, Chiayi County 61363, Taiwan. Electronic address: meiyen@mail.cgust.edu.tw.
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D001364:Awareness; D015519:Bone Density; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D015444:Exercise; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008607:Intellectual Disability; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan; D055815:Young Adult
keywords: Bone mineral density; Chronic disease; Osteoporosis; People with disabilities