Prevalence of fractures in women with intellectual disabilities: a chart review.
One in three women with IDs already has an adult fracture—start bone-health screening and calcium counselling before age 40.
01Research in Context
What this study did
Researchers looked at 93 women with intellectual disabilities in family medicine clinics.
They read every chart to count adult bone fractures and any osteoporosis care.
Average age when fractures happened was 41.7 years.
What they found
One out of every three women already had at least one adult fracture.
Most had never received bone density tests or calcium advice.
Fractures were common but treatment was rare.
How this fits with other research
Perez et al. (2015) found the same pattern in people with autism.
They also saw more hip and spine breaks, showing the risk is not just for women with ID.
Waldron et al. (2023) measured low bone mass in adults with Down syndrome.
Their work helps explain why fractures happen so early.
Together, these studies say bone checks should start before age 40, not after the first break.
Why it matters
You can add a quick bone-health screen to annual visits. Ask about past fractures, check calcium intake, and request a DEXA scan by age 35. Early action can prevent breaks and hospital stays.
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02At a glance
03Original abstract
BACKGROUND: Numerous studies have demonstrated high rates of osteoporosis and fractures in women with intellectual disabilities (IDs). All of the studies use either institutionalized women or women in the community recruited at adult day-care centres or specialty clinics. We examined the prevalence of fractures in women with IDs who attend a primary care clinic, and assessed osteoporosis-prevention/intervention activities. METHODS: This was a chart review study. Charts were identified of women with an ICD-9 diagnosis code for ID, Down syndrome or developmental disabilities. All charts reviewed were patients of one of 13 family medicine clinics affiliated with Department of Family Medicine, the University of Wisconsin. RESULTS: A total of 93 charts were reviewed. More than 32% (30/93) of the charts contained a history of an adult-onset fracture. Increasing age, being postmenopausal and taking anticonvulsant medications were significantly associated with having a fracture. The average age of first fracture was 41.7 years. Of the women with a fracture, 35.5% were placed on a medication to maintain bone density, 67.7% received a recommendation for a calcium supplement, and 38.7% obtained a bone density test. DISCUSSION: The prevalence of fractures in women with IDs attending a family medicine clinic was very high, and fractures occurred at young ages. Primary care providers need to consider women with IDs at a high risk for fractures and begin preventive counselling in young women.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2006.00872.x