Risk factors that place people with developmental disabilities at high risk for osteoporosis include: (a) small physical frame; (b) hypotonia; (c) reduced mobility; (d) vitamin D deficiency associated with anticonvulsant medication; and (e) frequent falls (Jaffe et al., 2001). Another risk factor that has not received much research attention is the onset of menopause in older women with developmental disabilities (http://www.thearc.org). Some research has provided evidence that women with Down syndrome may experience menopause at an earlier age than the general population, which means less estrogen is produced. Because estrogen is a factor in maintaining bone density, once this drop in production occurs, the individual becomes at greater risk for osteoporosis.

Research by Jaffe et al. (2001) examining bone mineral density for an institutionalized population of postmenopausal women with developmental disabilities found that a bone density measure of the calcaneus (heel) indicated there was a much higher degree of bone loss in this population than a group of age-matched controls. A more recent study by Jaffe and Timell (2003) examined bone mineral density in a group of institutionalized men with developmental disabilities and found that this group also had a significantly lower bone mineral density than a control population. This evidence indicates that both genders are at risk for osteoporosis and should be directed toward prevention interventions.

Osteoporosis Prevention Recommendations:

Exercise: weightbearing activities such as walking, running, or standing exercise programs are important parts of a prevention program. Exercise can also help to keep the individual at a healthy weight which can improve activity and function.

Quit Smoking: cigarette smoking decreases the body's ability to process calcium, and there is evidence that smokers have twice the risk of having a hip fracture than non-smokers.

Medication Effects: little research has been performed on the effect of Hormone Replacement Therapy (HRT) for women with developmental disabilities. Literature for women without disabilities provides evidence that there has been benefit in reducing osteoporosis using HRT. However, there are many associated health risks associated with HRT, and must be discussed with each individual's physician.

Further information about osteoporosis prevention for adults aging with developmental disabilities can be found at http://www.thearc.org that include recommendations from the Rehabilitation Research and Training Center on Aging with Developmental Disabilities at the University of Illinois at Chicago, and The Arc of Monmouth County, Tinton Falls, New Jersey.