Assessment & Research

Bone mineral density in adults with Down syndrome: a cross-sectional study in a Brazilian sample.

Fedrigo et al. (2023) · Journal of intellectual disability research : JIDR 2023
★ The Verdict

Most adults with Down syndrome have weak bones despite decent weight, grip, or activity, so plan for early screening and lifelong weight-bearing exercise.

✓ Read this if BCBAs writing adult day-hab or group-home exercise plans for clients with Down syndrome.
✗ Skip if Clinicians who only serve young children or non-Down autism cases.

01Research in Context

01

What this study did

Doctors in Brazil scanned the adults with Down syndrome. They checked bone density at the hip and spine.

They also weighed each person, tested grip strength, and asked how much they moved each week.

02

What they found

Six out of ten adults already had low bone mass or osteoporosis. Only weak links showed up with weight, strength, or activity.

In short, bones looked fragile even when everything else looked okay.

03

How this fits with other research

Geurts et al. (2008) saw the same low bone density in younger adults, so the problem starts early and stays.

Reza et al. (2013) proved kids with Down syndrome can gain bone if they do weight-bearing exercise three times a week. Waldron et al. (2023) now show the gain may fade by adulthood, because activity links only modestly to bone mass in grown-ups.

Meier et al. (2012) tracked kids and found they sit more and move less every year. That long slide into inactivity helps explain why exercise alone no longer protects the adult bone.

04

Why it matters

Expect fragile bones even in active, normal-weight clients. Schedule DEXA scans by age 30, add balance training to cut fall risk, and keep weight-bearing programs lifelong because early gains can erode if activity stops.

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Add ten minutes of weighted walking or stair climbing to the daily schedule and mark it on the data sheet.

02At a glance

Intervention
not applicable
Design
other
Sample size
26
Population
down syndrome
Finding
negative

03Original abstract

BACKGROUND: We aim to investigate the relationship between bone mass in a sample of Brazilian individuals with DS and handgrip strength, body mass index (BMI) and physical exercise. METHODS: Dual-energy X-ray emission densitometry analysis of bone mass in 26 individuals with DS (8 men and 18 women with a mean age of 30.7 ± 10.3 years) was conducted. Additionally, weight and height were measured to determine BMI, palmar grip strength was measured using a Jammar dynamometer®, and physical activity was classified using the International Physical Activity Questionnaire (IPAQ). RESULTS: In this sample, 2/15 (13.3%) individuals with age between 18 to 29 years had low BMD in the spine; 2/8 (25%) of those with age between 30 and 39 years also had low BMD in the spine and 2/3 (66.6%) with age ≥40 had low BMD in the femur. There were significant correlations between palmar grip strength and Z femoral neck score in women (P = 0.02) and between BMI and Z femoral neck score in men (P = 0.04). All other correlations lacked statistical significance (P > 0.05). CONCLUSIONS: Brazilian patients with DS showed a high prevalence of low bone mass. Traditional factors such as muscle strength, BMI and physical activity appear to have little effect on bone mineral density in this population.

Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13031