Prevalence of fractures in women with intellectual disabilities: a chart review

Abstract

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. 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. 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. 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.