MedWire News: Individuals with intellectual disabilities (ID) often have several risk factors for osteoporosis but do not receive adequate screening for the disease, UK researchers report.
"There has been increased awareness of osteoporosis in the general population, but the disorder has received limited consideration in people with ID," remark Radha Srikanth (Tees, Esk and Wear Valleys NHS Foundation Trust, Durham) and colleagues.
"Because of their increased life span, it is no longer valid to assume that osteoporosis is not a significant medical problem in this population," they add.
To determine the magnitude of the problem, Srikanth and team carried out a literature review to identify studies reporting the prevalence of osteoporosis and osteopenia in people with ID.
Among the 13 studies reviewed, osteoporosis prevalence rates ranged from 21% in a group of individuals attending community day centers to 78.5% among a group of institutionalized adults with ID.
In addition, most studies reported that individuals with ID presented with more than two osteoporosis risk factors, including, among others, reduced physical activity, low testosterone, early menopause in women, presence of Down's syndrome, poor nutrition, low vitamin D levels due to poor exposure to sunlight, and exposure to antiepileptic or antipsychotic medication.
Srikanth and team also carried out their own separate retrospective study of 149 individuals with ID.
They observed a high prevalence of risk factors associated with osteoporosis, namely use of antiepileptics (64%), immobility (23%), a history of falls (20%), and a history of fractures (11%).
A total of 80 (54%) patients fulfilled the Scottish Intercollegiate Guidelines Network criteria for osteoporosis screening, of whom only 32 (21%) had been referred at the time of the survey.
Among the patients who went on to have bone densitometry scans (n=18), 55% had osteoporosis and 33% had osteopenia.
Writing in the Journal of Intellectual Disability Research, Srikanth and co-authors say their findings indicate that clinicians should be screening for risk factors associated with low bone mineral density 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," they conclude.
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