2026 Volume 11 Article ID: 20260063
Objectives: This study examined whether lumbar spine bone mineral density (BMD) can distinguish extremity long bone fracture status in adults with severe motor and intellectual disabilities (SMID).
Methods: We retrospectively analyzed 86 adults with SMID who underwent dual-energy X-ray absorptiometry (DXA) between 2023 and 2024. Patients younger than 18 years at the first DXA examination and those with fractures only at sites other than the extremity long bones were excluded. The cohort consisted of 23 patients in the fracture group and 63 in the non-fracture group. Fracture history was reviewed from April 2015 to March 2025. Group comparisons were conducted. Binary logistic regression was performed using age and mean lumbar spine BMD as independent variables.
Results: The intraclass correlation coefficient was 0.939 (95% confidence interval, 0.909–0.960), indicating high reproducibility of BMD measurements. Mean lumbar spine BMD was lower in the fracture group than in the non-fracture group (0.486 ± 0.137 vs 0.551 ± 0.145 g/cm2; P = 0.067). Mean Z-scores were markedly low in both groups (−2.93 ± 1.16 vs −3.15 ± 1.17; P = 0.451). Among 23 patients with fractures, 20 patients sustained fractures before the first DXA examination and 3 patients sustained fractures after the first DXA examination. In logistic regression analysis, age was associated with fracture status (odds ratio, 1.057; 95% confidence interval, 1.017–1.099; P = 0.005), whereas the association of mean lumbar spine BMD was not significant.
Conclusions: Lumbar spine BMD alone may be insufficient to distinguish fracture status in adults with SMID.
