Osteoporosis in people with intellectual disabilities: a review and a brief study of risk factors for osteoporosis in a community sample of people with intellectual disabilities.
Adults with ID stack up risk factors for osteoporosis, yet scans stay rare—so put DEXA on the standing order sheet.
01Research in Context
What this study did
Mount et al. (2011) looked at every paper on weak bones in adults with intellectual disability.
They also ran a small survey to see how many people in one UK town had risk factors like seizures meds, falls, or little walking.
What they found
The review showed high rates of thin bones, seizure drugs, and falls.
The authors say adults with ID need routine bone scans.
How this fits with other research
Bao et al. (2017) later counted 753 Irish adults and found only 1 in 8 ever got a scan, proving the gap the review warned about.
Aznar et al. (2005) had already flagged seizure drugs and poor mobility as red flags; the 2011 paper bundles those clues into one big picture.
Gandelman-Marton et al. (2024) zoomed in on people who have both epilepsy and ID and found zero out of 68 had ever had a DXA scan, showing the problem is still alive today.
Why it matters
You can act now. Add "bone density referral" to the annual health check for every adult with ID, especially if they take seizure meds or walk less. One quick tick box can catch weak bones before the first fracture.
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02At a glance
03Original abstract
BACKGROUND: The population of people with intellectual disabilities (ID) is increasing and their health needs impact on primary and secondary healthcare specialities. One important aspect of their physical health is bone health as people with ID have increased risk factors associated with osteoporosis. It has been identified that this population has an increased prevalence of low bone mineral density (BMD), osteoporosis and osteopenia. The main contributory factors for low BMD are age, use of antiepileptics, immobility and diagnosis of Down's syndrome. METHODS: A literature search of electronic databases was undertaken. Studies that included people with ID were reviewed for the prevalence of osteoporosis and osteopenia. A cross-sectional survey was conducted in a community sample (n = 149) to screen for risk factors for osteoporosis. RESULTS: The majority of studies identified increased prevalence of osteoporosis and osteopenia with associated low BMD. In most studies individuals with ID presented with more than two risk factors. In our survey, we identified an increased prevalence of risk factors associated with osteoporosis, namely use of antiepileptics (64%), immobility (23%), history of falls (20%) and fractures (11%). We found that 54% of our sample fulfilled the criteria for screening. Of those who went on to have scans, 55% had osteoporosis and 33% had osteopenia. CONCLUSION: We conclude that we should be screening for the risk factors associated with low BMD 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.
Journal of intellectual disability research : JIDR, 2011 · doi:10.1111/j.1365-2788.2010.01346.x