Vitamin D, bone mineral density and risk of fracture in people with intellectual disabilities.
Daily vitamin D gives adults with ID a small bone boost, but you still need bone scans and fall precautions.
01Research in Context
What this study did
Researchers tracked adults with intellectual disability who kept taking vitamin D for about seven years. They checked spine bone density at the start and again at the end.
The team wanted to know if steady vitamin D helps bones in this group.
What they found
Spine bone density rose six percent. Still, most adults stayed osteopenic or osteoporotic.
In plain words, the vitamin helped a little, but bones stayed fragile.
How this fits with other research
Reyer et al. (2006) saw no link between vitamin D levels and actual fractures in 337 residents. Williams et al. (2019) now show a small bone gain, yet the high fracture risk remains. The two studies look opposite until you notice the first counted broken bones, the second counted bone density.
Stichter et al. (2009) proved daily oral vitamin D beats a yearly mega-shot for raising blood levels. Williams et al. (2019) extend that work by showing long-term daily use also nudges bone density upward.
de Wit et al. (2024) found very low vitamin D in adults with ASD. Together these papers flag a shared problem across neurodevelopmental groups: low levels are common, and steady daily dosing is the safest fix.
Why it matters
Keep every adult with ID on a daily vitamin D supplement. Check bone density anyway, because gains are modest and fragile bones stay common. Schedule DEXA scans alongside behavior plans, and document any falls as you would problem behavior.
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02At a glance
03Original abstract
BACKGROUND: People with intellectual disabilities (IDs) have very high rates of osteoporosis and fractures, to which their widespread vitamin D deficiency and other factors could contribute. We aimed to assess in people with IDs previously treated for vitamin D deficiency (1) long-term adherence to vitamin D supplementation and (2) bone mineral density (BMD), as an indicator for risk of fractures, according to vitamin D supplementation and other factors. METHOD: We recorded height, weight, medical, pharmacological, dietary and lifestyle assessment. Blood sample were taken for vitamin D and related analytes. dual-energy X-ray absorptiometry for BMD was performed. RESULTS: Of 51 study participants (mean [standard deviation, SD] age 51.5 [13.6] years, 57% male), 41 (80.4%) were taking vitamin D and 10 were not. Mean [SD] serum vitamin D was 81.3 [21.3] vs. 25.2 [10.2] nmol/L (P < 0.0001), respectively. Thirty-six participants underwent a dual-energy X-ray absorptiometry scan, which showed osteoporosis in 23.7% and osteopenia in 52.6%. Participants on vitamin D had higher BMD than those who were not, a statistically significant difference when confounders (lack of mobility and hypogonadism) were removed. BMD was significantly different according to mobility, particularly in wheelchair users, in whom hip BMD was 33% lower (P < 0.0001) than in participants with normal mobility. Participants still taking vitamin D showed a 6.1% increase in BMD at the spine (P = 0.003) after mean [SD] 7.4 [1.5] years vitamin D treatment. CONCLUSIONS: In people with IDs and previous vitamin D deficiency, BMD increases on long-term vitamin D supplementation. However, additional strategies must be considered for osteoporosis and fracture prevention in this population.
Journal of intellectual disability research : JIDR, 2019 · doi:10.1111/jir.12581