Intellectual disabilities and risk of fractures: A population-based cohort study

Summary: In this retrospective cohort study, people with intellectual disabilities (ID) had higher risks of fractures, including any fractures, vertebral fractures, and hip fractures, compared to those without ID. The risk was especially pronounced in younger adults (20–39 years), emphasizing the importance of targeted healthcare interventions in individuals with ID. Background: Life expectancies of individuals with ID have increased over the past few decades. We aimed to evaluate the risk of any fractures, vertebral fractures, and hip fractures in people with ID compared to those without ID. Methods: This retrospective cohort study analysed Korean National Disability Registry data with the Korean National Health Insurance Service database. A total of 3,815,545 individuals who underwent national health examinations in 2009 were followed until 2020. Cox-proportional hazard analyses were performed to estimate the hazard ratios (HRs) of any fractures, vertebral fractures, and hip fractures in individuals with compared to those without ID with adjustment for covariates. Results: During a mean follow-up period of 10.0 years, among 3582 individuals with ID, there were 207 cases of any fractures, 47 cases of vertebral fractures, and 27 cases of hip fractures. The multivariable-adjusted hazard ratios for risk of any fractures, vertebral fractures, and hip fractures in the ID group compared to those without ID were 1.69 (95% CI 1.47–1.94), 2.07 (95% CI 1.55–2.75), and 3.01 (95% CI 2.07–4.39), respectively. In subgroup analysis, individuals with ID aged 20–39 years had higher risk of fractures compared to those in older age groups. Conclusion: Individuals with ID are at an increased risk of any fractures, vertebral fractures, and hip fractures compared to those without ID. Healthcare professionals should be aware of the elevated risk of fractures in this population.