An exploration of the bone health of older adults with an intellectual disability in Ireland.
Irish adults with ID show high fracture history and near-zero bone screening—add DEXA to routine checks.
01Research in Context
What this study did
Bao et al. (2017) asked 753 Irish adults with intellectual disability about their bones.
They counted who had a doctor’s osteoporosis diagnosis, who had already broken a bone, and who ever had a DEXA scan.
What they found
One in five people had already suffered a fracture.
Only one in twelve had ever received a bone scan.
Older women were at highest risk, yet screening was almost absent.
How this fits with other research
Mount et al. (2011) reviewed earlier work and warned that adults with ID carry many risks—seizure drugs, falls, low mobility—but still rarely get screened.
Seven years later, Gandelman-Marton et al. (2024) found zero DEXA scans in 68 adults with epilepsy plus ID, showing the gap is not closing.
Robertson et al. (2013) help explain why: the same group falls once per person each year, so every missed scan invites future breaks.
Why it matters
You can add a DEXA referral checkbox to the annual health check today. It takes seconds, costs little, and can prevent painful fractures that drive hospital stays and lost mobility.
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02At a glance
03Original abstract
BACKGROUND: Many risk factors have been confirmed for poor bone health among the general population including age, gender and corticosteroid use. There is a paucity of investigation among people with intellectual disability; however, research points to differing risks namely anti-epileptic medication use, Down syndrome and poor behaviour lifestyle. METHODS: Data was extracted from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing in Ireland. In total, 753 participants took part, and data was gathered on participants' health status, behavioural health, health screenings and activities of daily living. The prevalence of osteoporosis and related risk factors were specifically examined. RESULTS: Overall, 8.1% reported a doctor's diagnosis of osteoporosis with over 20% reporting history of fracture. Risk identified included older age (P < 0.0001), female gender (P < 0.0001), difficulty walking (P < 0.0001) with older age and being female the stronger predictors for osteoporosis, odds ratio = 6.53; 95% confidence interval 2.82-15.11 and odds ratio = 4.58; 95% confidence interval 2.29-9.17, respectively. There was no gender difference regarding the level of fractures; however, epilepsy and anti-epileptic medication were strong predictors. Overall, 11.1% attended for bone screening diagnostics. CONCLUSION: Despite low levels of reported doctor's diagnosis of osteoporosis risk factor prevalence was high. Considering the insidious nature of osteoporosis and the low levels of diagnostic screening, prevalence could be possibly higher.
Journal of intellectual disability research : JIDR, 2017 · doi:10.1111/jir.12273