Bone mass in young adults with Down syndrome.
Down syndrome adults have real spine bone loss beyond body-size effects—prescribe weight-bearing exercise and sunlight.
01Research in Context
What this study did
Researchers measured bone density in the adults with Down syndrome. They compared them to the adults without the condition, matched for age and sex.
The team used two scans: a standard hip and spine X-ray, plus a 3-D spine scan. They also asked about time in the sun and weekly exercise.
What they found
Adults with Down syndrome had lower bone density at every site. The gap was biggest in the spine, even after adjusting for their smaller body size.
Low sunlight and little exercise predicted the spine deficit. Hip differences disappeared once body size was accounted for.
How this fits with other research
Reza et al. (2013) tested a fix: kids with Down syndrome did weight-bearing exercise three times a week. Their hip bone density rose more than kids who only took calcium pills.
Waldron et al. (2023) saw the same low-bone pattern in Brazilian adults, showing the problem is global. Their data say normal grip strength or BMI does not protect bones.
Meier et al. (2012) tracked kids’ step counters. By early teens, most kids with Down syndrome sat almost all day. That sedentary trend matches the low-activity predictor seen here.
Why it matters
Low spine bone density is not just because people with Down syndrome are smaller. You can target it. Add short bouts of weight-bearing exercise and outdoor sun breaks to daily programs. Track minutes, not miles—five stair climbs or a ten-minute walk count. Pair this with fall-prevention balance work from Perry et al. (2024) to cut fracture risk.
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02At a glance
03Original abstract
BACKGROUND: Down syndrome (DS) is a frequent cause of intellectual disability. With the increasing life expectancy of these patients, concerns have been raised about the risk of osteoporosis. In fact, several investigators have reported a reduced bone mass in DS. However, the results may be confounded by comorbid diseases, and differences in lifestyle habits and body size. Therefore, we planned to determine anthropometric and lifestyle factors influencing bone mineral density (BMD) in young adults with DS. METHODS: Thirty-nine patients with DS (mean age 26 years) and 78 controls were studied. Areal BMD was measured by dual x-ray densitometry (DXA); volumetric BMD at the lumbar spine and femoral neck was estimated with published formulae. RESULTS: DS patients had lower areal BMD than controls at all regions (spine, hip and total body). Height and projected bone area were also lower. There were no differences between both groups regarding estimated volumetric BMD at the femoral neck. However, spine volumetric BMD was also lower in DS than controls. In multivariate analysis, DS, male sex, little physical activity and low sunlight exposure were associated with lower spine volumetric BMD; on the other hand, fat mass and sunlight exposure were associated with femoral neck volumetric BMD. CONCLUSION: This study shows that patients with DS had a reduced areal BMD, but it is in part a consequence of the reduced body size, particularly at the femoral neck. Physical activity and sunlight exposure are associated to volumetric BMD and should be stimulated in order to maintain an adequate bone mass in these patients.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2007.00992.x