Prevalence of low bone-mineral density among mentally retarded and developmentally disabled residents in intermediate care.

OBJECTIVE

To explore the prevalence of low bone-mineral density (BMD) and related fractures among mentally retarded and developmentally disabled residents in intermediate care settings.

DESIGN

Cross-sectional study.

SETTING

Intermediate care facilities for mentally retarded and developmentally disabled (< 16 beds) and group homes (> or = 16 beds) in the mid-western United States.

PARTICIPANTS

A total of 360 residents were selected for the initial study group; 119 were excluded, 241 remained to study completion.

INTERVENTION: Antiresorptive therapy with alendronate 10 mg daily and calcium 500 mg with vitamin D 200 IU, three times daily, for participants in the osteoporosis range; calcium 500 mg with vitamin D 200 IU three times daily for participants in the osteopenia range.

MAIN OUTCOME MEASURES: Low BMD and related fractures. Secondary measures included medications associated with bone loss, mobility level, medical diagnoses associated with bone loss, diagnosis of bone disorders, level of mental retardation, pharmacotherapy and calcium supplementation, and demographic characteristics.

RESULTS

The prevalence of low BMD in this study group was 78.8% (n=189), with 157 (65.1%) participants in the osteoporosis range and 32 (13.3%) in the osteopenia range. The average age was 45.8 years, with residents ranging from 20 to 91 years; 67.6% (n=163) were male. Nearly three-fourths of participants were in either the severe or profound range of mental retardation. Forty residents received multiple medications, contributing to bone loss. The incidence of documented nontraumatic fractures was 3.5%.

CONCLUSIONS

Low BMD is prevalent in mentally retarded and developmentally disabled residents in intermediate care settings with low mobility and other risk factors. Consultant pharmacists have the opportunity to suggest appropriate pharmacotherapy for the treatment of low BMD in this setting.