Abstract

Background: People with Down syndrome (DS) are a high “at risk” group to develop osteoporosis. Increased morbidity associated with older age, higher prevalence of Alzheimer dementia, hypotonia, hypogonadism, and thyroid disease, are all features of DS and predispose this cohort to musculoskeletal complications. Methods: The Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing (IDS-TILDA) is a representative study of the aging of adults with intellectual disability in Ireland. The sample (N = 753) included 147 people with DS. Data was gathered on participants’ health status, behavioural health, health screenings and activities of daily living. The prevalence of osteoporosis and related risk factors among people with DS was specifically examined. Findings: Of the 147 participants with DS, 9.4% reported a doctor’s diagnosis of osteoporosis; a much lower figure than prevalence of risk factors would suggest. Predisposing factors identified included higher than general population rates of thyroid disease (37.4%), epilepsy (19.3%), sedentary lifestyle (51.7%) and the majority of the females reporting having experienced menopause (61%). Bone health screening was low at (8%) despite the presence of such high levels of risk factors in this population. Conclusion: Given the risk factor findings and the hidden nature of osteoporosis, underreported incidence among people with Down syndrome seems probable. Further investigations and systematic screening are required.

Highlights

  • Osteoporosis and osteopenia are chronic skeletal conditions characterized by low bone density and microarchitectural deterioration of bone tissue [1] [2] [3]

  • The World Health Organization (WHO), the International Osteoporosis Foundation (IOF) and bone health research literature, identify a number of non-modifiable and modifiable risk factors associated with the development of osteoporosis and osteopenia

  • The confirmed prevalence of thyroid disease, early menopause, specific medications that interfere with bone metabolism, and levels of inactivity and sedentary lifestyle, all culminate in increased likelihood of developing osteoporosis or osteopenia

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Summary

Introduction

Osteoporosis and osteopenia are chronic skeletal conditions characterized by low bone density and microarchitectural deterioration of bone tissue [1] [2] [3]. The World Health Organization (WHO), the International Osteoporosis Foundation (IOF) and bone health research literature, identify a number of non-modifiable and modifiable risk factors associated with the development of osteoporosis and osteopenia. Non-modifiable risks include female gender, increased age, family history of osteoporosis, and being Caucasian. The prevalence of osteoporosis and related risk factors among people with DS was examined. Predisposing factors identified included higher than general population rates of thyroid disease (37.4%), epilepsy (19.3%), sedentary lifestyle (51.7%) and the majority of the females reporting having experienced menopause (61%). Bone health screening was low at (8%) despite the presence of such high levels of risk factors in this population. Conclusion: Given the risk factor findings and the hidden nature of osteoporosis, underreported incidence among people with Down syndrome seems probable.

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