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Quantitative examination of the bone health status of older adults with intellectual and developmental disability in Ireland: a cross-sectional nationwide study
  1. Éilish Burke1,
  2. Rachael Carroll1,
  3. Máire O’Dwyer2,
  4. James Bernard Walsh3,
  5. Philip McCallion4,
  6. Mary McCarron5
  1. 1School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Ireland
  2. 2School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, The University of Dublin, Dublin, Ireland
  3. 3Centre for Medical Gerontology, Trinity College Dublin, The University of Dublin, Dublin, Ireland
  4. 4School of Social Work, Temple University, Philadelphia, Pennsylvania, USA
  5. 5Dean of the Faculty of Health Sciences, Trinity College Dublin, The University of Dublin, Dublin, Ireland
  1. Correspondence to Dr Éilish Burke; eburke7{at}


Objectives (1) To investigate the prevalence of osteopenia and osteoporosis among adults with intellectual disabilities (IDs) and (2) to examine alternative optimal bone screening techniques.

Design Observational cross-sectional study.

Setting Wave 2 (2013–2106) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing.

Participants A national representative sample of 604 male and female persons with ID aged 43 years and over. In total, 575 participants completed quantitative ultrasound (QUS) measurements for one or both feet.

Outcome measures Participants underwent health assessments consisting of eight objective health measures including the standardised QUS of the calcaneus bone using a GE Lunar Achilles. A preinterview questionnaire and face-to-face interview were also completed.

Results Objectively QUS identified poorer rates of bone health in people with ID overall with 74% indicating evidence of osteopenia (33.2%) or osteoporosis (41%). Females scored lower than males in the QUS t-scores −2.208 (±1.77) versus −1.78(±1.734). Bone status was stratified by gender (p=0.114), age (p=0.003), level of ID (p<0.0001) and living circumstance (p<0.0001).

Conclusions This study has shown the prevalence of poor bone health in people with ID is substantial implying an increased risk of fracture due to reduced skeletal integrity. QUS screening has been shown to be useful when combined with clinical risk factors.

  • intellectual disability
  • bone health
  • quantitative ultrasound
  • fracture
  • osteoporosis

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  • Contributors EB, RC, MO, JBW, PM and MM contributed to the overall conception and design of the study. EB and RC undertook the data extraction. EB and RC undertook the statistical analyses, EB wrote the first draft of the manuscript. EB, JBW, PM and MM revised the manuscript. MO was the researcher pharmacist who conducted the coding and trained the field researchers in medicine recording. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed to the interpretation of results and drafting of the manuscript. All authors read and approved the final manuscript. EB and MM are the guarantors.

  • Funding This research was funded by the Department of Health in Ireland and managed by the Health Research Board. Grant Number HRA-PHS-2012-14. The funding bodies did not play a role in the study design or writing of the manuscript.

  • Disclaimer The views expressed are those of the authors and are not necessarily those of the Department of Health, The Health Research Board or Trinity College Dublin.

  • Competing interests None declared.

  • Ethics approval Ethics for the IDS-TILDA study, which included the health assessments, was obtained from the faculty ethics committee and all participating service providers.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Due to the nature and small population from which this sample was drawn the participants could possibly be identifiable. All data are held within an encrypted secured drive only accessed by assigned personnel. Those wishing to access may do so with the permission of the PI. All interested researchers may apply to the study.

  • Patient consent for publication Not required.

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