Identification of low bone mass in a developmental center: finger bone mineral density measurement in 562 residents

The objective of this study was to measure finger bone mineral density (BMD) in residents of a developmental center.

A cross-sectional descriptive study performed during the residents' annual physical examination.

This study was conducted at a long-term care facility for people with severe developmental disabilities (mental retardation, cerebral palsy, epilepsy, and autism).

Study participants included 562 (67%) of the 833 residents aged 30 years or more on whom we could measure BMD.

We measured BMD by peripheral dual-energy x-ray absorptiometry (DXA) on the residents' middle fingers by Accudexa. The instrument converted the BMD values into T-scores relative to the manufacturer's reference young healthy population. We retrieved the residents' clinical variables from a centralized database.

T-scores for the 562 residents were: <-2.5 standard deviation (SD) (osteoporotic): 98 (17%), -2.5 SD>t <-1 SD (osteopenic): 156 (28%), and >-1 SD (normal): 308 (55%). Multivariate regression analysis revealed that BMD was significantly lower in residents (compared with their counterparts) with inability to ambulate, male gender, white race, quadriplegia, profound mental retardation, and older age.

There is a need for heightened osteoporosis surveillance and preventive effort in this population in which almost half of the residents had previously undiagnosed subnormal BMD, including one sixth who had osteoporosis.