Characteristics associated with bone mineral density screening in a sample of adults with intellectual disabilities
Dreyfus, Deborah Elizabeth
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Adults with Intellectual Disability (ID) are at an elevated risk of osteoporosis based on lower peak bone mass and medical characteristics. However, there is little data as to how the medical characteristics affect screening or at what ages people are being screened. Methods: A secondary cross-sectional data analysis of was conducted of 4777 adults witl1 Intellectual Disability to determine characteristics associated with an elevated risk for osteoporosis and receipt of bone density screening. Hypotheses were that increasing age, use of antiseizure medication, living in a 24 hour residential setting, and receiving a flu vaccine increased the likelihood of screening. Bivariate analyses were initially performed, tl1en data were stratified by gender and logistic regressions were performed. Findings: 22.2% of the sample in this study received bone density screening. Bivariate odds ratios identified each of the hypothesized variables as significantly associated with receiving screening. Additionally, many of the covariates analyzed identified significant associations with receiving screening.Data were then stratified by gender and evaluated in a logistic regression. In men, increasing age, tl1e use of antiepileptic medication (adjusted odds ratio (OR) 1.5; 95% confidence interval (CI) 1.2-2.0), and receiving the flu vaccine (adjusted OR 1.5; 95% CI 1.2-2.0) were associated witl1 an increased likelihood of screening, controlling for confounding. Living in a 24 hour residential setting was not significantly associated with screening (adjusted OR 1.2; 95% CI 0.91-1.6). In women, increasing age, the use of antiepileptic medication (adjusted OR 1.5; 95% CI 1.2-1.9), receiving the flu vaccine (adjusted OR 1.4; 95% CI 1.1-1.8), and living in a 24 hour residential setting (adjusted OR 1.4; 95% CI 1.1 -1.8) were all significantly associated with receiving screening. A history of Down syndrome, noted to increase risk of osteoporosis, was associated with a decreased likehl1ood of screening (adjusted OR 0.67; 95% CI 0.4 7-0. 94) in women, although it was not a significant association in men. Conclusions: While most variables related to osteoporosis are associated with an increased likelihood of screening, screening rates among in adults witl1 ID were low. Additionally, men and women have differences in variables related to screening. Better education and improved awareness may increase rates.
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