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Background People with intellectual disabilities (ID) have very high osteoporosis and fractures rates, to which their widespread vitamin D deficiency and other factors could contribute. We aimed to assess in ID people 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 Height, weight, medical, pharmacological, dietary and lifestyle assessment; blood sample for vitamin D and related analytes; Dual-energy X-ray Absorptiometry (DXA) for BMD. Results Of 51 study participants (mean [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 DXA 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, 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 intellectual disabilities and previous vitamin D deficiency, bone mineral density increases on long-term vitamin D supplementation. However, additional strategies must be considered for osteoporosis and fracture prevention in this population.

Type

Journal article

Journal

Journal of Intellectual Disability Research

Publisher

Wiley

Publication Date

28/11/2018

Addresses

Valeria Frighi, University of Oxford, Psychiatry, Warneford Lane, Oxford, OX3 7JX, United Kingdom

Keywords

intellectual disabilities; vitamin D; bone mineral density; osteoporosis; fracture; hypogonadism; impaired mobility