Risk factors for low bone mineral density in individuals residing in a facility for the people with intellectual disability.
Poor mobility is the top fixable warning sign for weak bones in adults with ID—screen it and refer for scans.
01Research in Context
What this study did
The team looked at adults with intellectual disability living in one large facility.
They checked bone density and asked about medicine, smoking, height, and how well each person could move.
The goal was to spot which traits go hand-in-hand with weak bones.
What they found
People who could not walk or needed help walking had the weakest bones.
Taking seizure medicine, smoking, being short, and white ethnicity also linked to low bone density.
Among these, poor mobility was the strongest factor staff can actually change.
How this fits with other research
Mount et al. (2011) pooled many studies and listed the same risks—anticonvulsants and immobility—supporting the 2005 list.
Bao et al. (2017) later tracked 753 Irish adults and found one in five had already broken a bone, showing these risks turn into real fractures.
Gandelman-Marton et al. (2024) revealed that none of 68 adults with epilepsy plus ID had ever received a recommended DXA scan, proving the risk is noticed on paper but ignored in practice.
Why it matters
You can add two quick items to annual assessments for any adult with ID: ask "Can the person walk without help?" and check if they take seizure drugs. If either answer is yes, refer for a bone scan and start fall-prevention training. Acting early on mobility beats trying to fix fractures later.
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02At a glance
03Original abstract
BACKGROUND: Individuals with intellectual disability (ID) are known to have a high prevalence of both low bone mineral density (BMD) and fractures with significant attendant morbidity. Effective strategies aimed at reducing fractures will be facilitated by the identification of predisposing risk factors. METHODS: Bone mineral density was measured by quantitative ultrasound of the calcaneus performed on 79 women and 132 men residing in a facility for adults with ID. Multiple variable logistic regression analysis was performed to determine the significance of risk factors for low BMD. RESULTS: Mobility impairment consistently appeared to be a significant risk factor for low BMD regardless of age or sex and especially for middle-aged men with profound ID. Further risk was identified for postmenopausal women taking enzyme inducing anticonvulsant medications and middle-aged men who were either smokers or tended to be short. Hispanic followed by Caucasian origin also put middle-aged males at a greater risk than their African-American counterparts. CONCLUSIONS: Specific risk factors for low BMD, some of which have potential for modification, were identified in the study population. Targeted strategies for risk factor reduction may result in a decrease in the high rate of fractures among these individuals.
Journal of intellectual disability research : JIDR, 2005 · doi:10.1111/j.1365-2788.2005.00700.x