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Prevalence of and risk factors for osteoporosis in adults with acquired brain injury

Abstract

Background

Low bone mineral density (BMD) is common in older people with stroke, particularly in the paretic limb. Younger people with acquired brain injury (ABI), of all causes, are at increased risk of low BMD.

Aims

To examine prevalence of low BMD, based on World Health Organisation diagnostic criteria, in patients with ABI.

Methods

This is a cross-sectional study of 112 ABI patients. All completed a questionnaire, had laboratory investigations and DXA assessment of lumbar spine and one or both hips.

Results

Mean age ± SD of participants was 45.7 ± 13.7 years. Risk of vitamin D deficiency (25-OHD < 30 nmol/L) occurred in 27.7 %, 34.3 % had adequate levels (30–50 nmol/L) and 36.6 % had levels in excess of this. Based on T-scores, 41.1 % had osteopenia and 21.4 % had osteoporosis. A Z score of −1 or less but greater than −2 occurred in 25 %; a further 21.4 % had a Z score of −2 or less. Patients who could walk outdoors had significantly higher BMD at the neck of femur than those who walked indoors only and those who could not walk at all (p < 0.001). On multiple linear regression analysis, ambulatory ability and duration of disability were independent predictors of BMD at sound neck of femur and total proximal femur.

Conclusions

Osteopenia and osteoporosis are common in young adults with ABI compared with the general population. Bone heath monitoring should form part of the long-term follow-up of this patient group.

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Authors

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Correspondence to É. Smith.

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Funding

This study was funded by the National Medical Rehabilitation Trust Ltd. (There is no research grant number).

Conflict of interest

Dr. Éimear Smith declares she has no conflict of interest. Dr. Catherine Comiskey declares she has no conflict of interest. Dr. Áine Carroll declares she has no conflict of interest.

Ethical standards

All procedures performed in this study, involving human participants, were in accordance with the ethical standards of the NRH ethics committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Smith, É., Comiskey, C. & Carroll, Á. Prevalence of and risk factors for osteoporosis in adults with acquired brain injury. Ir J Med Sci 185, 473–481 (2016). https://doi.org/10.1007/s11845-016-1399-5

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  • DOI: https://doi.org/10.1007/s11845-016-1399-5

Keywords

  • Osteoporosis
  • Fracture risk
  • Dual energy X-ray absorptiometry
  • Stroke
  • Acquired brain injury
  • Traumatic brain injury