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爱尔兰智障和发育障碍老年患者骨健康状况的定量检查:一项全国性横断面研究。

Quantitative examination of the bone health status of older adults with intellectual and developmental disability in Ireland: a cross-sectional nationwide study.

机构信息

School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin, Ireland.

School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, The University of Dublin, Dublin, Ireland.

出版信息

BMJ Open. 2019 Apr 15;9(4):e026939. doi: 10.1136/bmjopen-2018-026939.

Abstract

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.

摘要

目的

(1)调查智力障碍成年人(ID)中骨量减少和骨质疏松症的患病率,(2)研究替代的最佳骨筛查技术。

设计

观察性横断面研究。

地点

爱尔兰老龄化纵向研究的智力障碍增刊第 2 波(2013-2016 年)。

参与者

年龄在 43 岁及以上的具有代表性的全国性男性和女性 ID 样本共 604 人。共有 575 名参与者完成了一只或两只脚的定量超声(QUS)测量。

结果

参与者接受了健康评估,包括八项客观健康指标,包括使用 GE Lunar Achilles 对跟骨进行标准化 QUS。还完成了预访谈问卷和面对面访谈。

结论

本研究表明,ID 人群的骨健康状况较差,总体上有 74%的人存在骨量减少(33.2%)或骨质疏松症(41%)的证据。女性的 QUS t 分数低于男性,分别为-2.208(±1.77)和-1.78(±1.734)。骨状态按性别(p=0.114)、年龄(p=0.003)、智力障碍程度(p<0.0001)和生活环境(p<0.0001)分层。

总体而言,QUS 识别出 ID 人群的骨健康状况较差,表明由于骨骼完整性降低,骨折风险增加。QUS 筛查与临床危险因素相结合已被证明是有用的。

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