Identification of Low Bone Mass in a Developmental Center: Finger Bone Mineral Density Measurement in 562 Residents

Lohiya, Ghan-Shyam; Tan-Figueroa, Lilia; Iannucci, Anita L.

doi:10.1016/s1525-8610(04)70004-3

Cited by 28 publications

(33 citation statements)

References 20 publications

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“…[43][44][45][46][47] A 2006 review focusing on women with ID highlighted risk factors, including inactivity, long-term anticonvulsant use, and possible Down syndrome. 48 Multiple previous studies documented the high rates of osteopenia/osteoporosis in adults with ID and cited the same risk factors 49,50 with the addition of low vitamin D levels. 51 …”

Section: Other Screening Testsmentioning

confidence: 96%

Screening Tests for Adults with Intellectual Disabilities

Wilkinson¹,

Culpepper²,

Cerreto³

2007

The Journal of the American Board of Family Medicine

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Adults with intellectual disabilities need thoughtful, well-coordinated primary care from family physicians. However, evidence-based screening recommendations are lacking. We examined screening recommendations for common preventable conditions using the US Preventative Service Task Force guidelines. We also reviewed the literature about the prevalence of these conditions in adults with intellectual disabilities. Obesity, osteoporosis, and smoking are more prevalent in adults with intellectual disabilities, and enhanced screening for these conditions is recommended. Abnormal Papanicolaou smears and cervical cancer are less common in adults with intellectual disabilities and screening recommendations should be individualized. We also discussed strategies to make screening procedures less stressful for these patients. The term "intellectual disabilities" (ID) refers to the condition of people with disabilities characterized by significant limitations both in cognitive functioning and adaptive behavior (conceptual, social, and practical adaptive skills) that originate before age 18 (Table 1). As used here, the term intellectual disabilities is synonymous with the term "mental retardation," a term that many people with ID dislike because it is stigmatizing and is frequently used as a global summary about complex human beings with a wide range of gifts, abilities, and needs. Challenges or limitations may be partially determined by the requirements of the environment in which people with ID live; the degree of disability may vary over time depending on the skills and supports the patient needs to function in his or her current environment. Adults with ID are living longer because of improved medical care, technology, and environmental conditions. They are also more likely to live in community-based settings instead of large institutions.

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Section: Other Screening Testsmentioning

confidence: 96%

Screening Tests for Adults with Intellectual Disabilities

Wilkinson¹,

Culpepper²,

Cerreto³

2007

The Journal of the American Board of Family Medicine

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“…9 Immune mechanisms may also mediate the vulnerability to autism conferred by recently described 16p11.2 microdeletions. 49 Another predicable pathophysiological consequence of an excessive, immune-driven Ca 2 þ entry into cells would be a progressive decrease in bone density, which has been described in at least two reports 50,51 and may be frequently overlooked especially in younger patients. Finally, an 8-year-old female control (case no.…”

Section: à1688mentioning

confidence: 99%

Altered calcium homeostasis in autism-spectrum disorders: evidence from biochemical and genetic studies of the mitochondrial aspartate/glutamate carrier AGC1

et al. 2008

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Autism is a severe developmental disorder, whose pathogenetic underpinnings are still largely unknown. Temporocortical gray matter from six matched patient-control pairs was used to perform post-mortem biochemical and genetic studies of the mitochondrial aspartate/glutamate carrier (AGC), which participates in the aspartate/malate reduced nicotinamide adenine dinucleotide shuttle and is physiologically activated by calcium (Ca(2+)). AGC transport rates were significantly higher in tissue homogenates from all six patients, including those with no history of seizures and with normal electroencephalograms prior to death. This increase was consistently blunted by the Ca(2+) chelator ethylene glycol tetraacetic acid; neocortical Ca(2+) levels were significantly higher in all six patients; no difference in AGC transport rates was found in isolated mitochondria from patients and controls following removal of the Ca(2+)-containing postmitochondrial supernatant. Expression of AGC1, the predominant AGC isoform in brain, and cytochrome c oxidase activity were both increased in autistic patients, indicating an activation of mitochondrial metabolism. Furthermore, oxidized mitochondrial proteins were markedly increased in four of the six patients. Variants of the AGC1-encoding SLC25A12 gene were neither correlated with AGC activation nor associated with autism-spectrum disorders in 309 simplex and 17 multiplex families, whereas some unaffected siblings may carry a protective gene variant. Therefore, excessive Ca(2+) levels are responsible for boosting AGC activity, mitochondrial metabolism and, to a more variable degree, oxidative stress in autistic brains. AGC and altered Ca(2+) homeostasis play a key interactive role in the cascade of signaling events leading to autism: their modulation could provide new preventive and therapeutic strategies. Molecular Psychiatry (2010) 15, 38-52; doi: 10.1038/mp.2008.63; published online 8 July 200

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“…[43][44][45][46][47][48] Relatively fewer studies have investigated the risk factors for low bone density within the population of adults with ID-for example, epilepsy 49 or Down syndrome. 50 Adults with ID who live in group homes have high facture rates compared with the general population.…”

Section: Osteoporosismentioning

confidence: 99%

Primary Care for Women with Intellectual Disabilities

Wilkinson¹,

Cerreto²

2008

The Journal of the American Board of Family Medicine

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Women with intellectual disabilities (ID) need thoughtful, well-coordinated care from primary care physicians. They are particularly susceptible to experiencing disparities in care because of varied participation in shared decision making. This review of the current literature comments on the quantity and quality of existing studies regarding several key women's health issues: menstrual disorders, cervical and breast cancer screening, contraception, and osteoporosis. A review of the current thinking regarding ethical and legal issues in medical decision making for these women is also provided. We found that there are several high-quality studies recommending early and frequent screening for osteoporosis, which is more common in women with ID. Smaller and fewer studies comment specifically on techniques for accomplishing the gynecological examination in women with ID, although the cervical cancer screening recommendation should be individualized for these patients. Consensus data on the management of menstrual problems and contraception in women with ID is provided. There are some data on breast cancer incidence but few articles on methods to improve screening rates in women with ID. Intellectual disability (ID) refers to a disability that is characterized by significant limitations both in cognitive functioning and in adaptive behavior (conceptual, social, and practical Women's health issues are important concerns among those with ID. In the past 40 years, it has been suggested that women's health should shift to a focus tailored to the individual patient, taking into account her personal beliefs and respecting her choices. The preface to the 1984 edition of Our Bodies, Our Selves states its goals "to reach as many women as possible with the tools which will enable them to take greater charge of their own health care and their lives, deal with the existing medical system and fight wherever possible for improvements and changes."6 While physicians' responsibilities to regard women as equal partners in making decisions about their health care has been debated, 7 patients' reproductive rights and choices have remained an important topic of discussion. Women with ID, however, benefit unevenly from this change in thinking. It is unclear how women who may lack some of the skills to make everyday decisions should partner in decisions about their health care. In addition, in a field where research has lagged on women's health topics, how do we interpret the existing evidence base for women with This article was externally peer reviewed.

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Identification of Low Bone Mass in a Developmental Center: Finger Bone Mineral Density Measurement in 562 Residents

Cited by 28 publications

References 20 publications

Screening Tests for Adults with Intellectual Disabilities

Screening Tests for Adults with Intellectual Disabilities

Altered calcium homeostasis in autism-spectrum disorders: evidence from biochemical and genetic studies of the mitochondrial aspartate/glutamate carrier AGC1

Primary Care for Women with Intellectual Disabilities

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