Risk factors for low bone mineral density in individuals residing in a facility for the people with intellectual disability.

BACKGROUND: Individuals with intellectual disability (ID) are known to have a high prevalence of both low bone mineral density (BMD) and fractures with significant attendant morbidity. Effective strategies aimed at reducing fractures will be facilitated by the identification of predisposing risk factors. METHODS: Bone mineral density was measured by quantitative ultrasound of the calcaneus performed on 79 women and 132 men residing in a facility for adults with ID. Multiple variable logistic regression analysis was performed to determine the significance of risk factors for low BMD. RESULTS: Mobility impairment consistently appeared to be a significant risk factor for low BMD regardless of age or sex and especially for middle-aged men with profound ID. Further risk was identified for postmenopausal women taking enzyme inducing anticonvulsant medications and middle-aged men who were either smokers or tended to be short. Hispanic followed by Caucasian origin also put middle-aged males at a greater risk than their African-American counterparts. CONCLUSIONS: Specific risk factors for low BMD, some of which have potential for modification, were identified in the study population. Targeted strategies for risk factor reduction may result in a decrease in the high rate of fractures among these individuals.

Monograph series on aging-related diseases: XI. Glaucoma.

In Canada, glaucoma is the second leading cause of blindness in people aged 50 and over, with primary open-angle glaucoma (POAG) accounting for 90% of all cases. Prevalence of POAG increases with age, and the condition is found more commonly among blacks than whites. Elevated intraocular pressure is an important risk factor for the disease; however, its positive predictive value for the presence of disease is poor. Prevalence of primary angle-closure glaucoma also increases with age, occurs more frequently among the Inuit and Asians, and has been reported to be more common among women. There are various diagnostic methods used to determine the presence or absence of glaucoma, but none can effectively identify the disease in its early stages unless routine screening is conducted. Current treatment of glaucoma is aimed at lowering intraocular pressure, which usually, but not always, stops disease progression.