9-10 Burning Questions - Scaphoid fracturePeople with learning disabilities have a high risk of osteoporosis and fractures, which could partly be as a result of vitamin D deficiency, a new study has suggested.

Studies have shown that individuals with learning disabilities who live in institutions are likely to have reduced exposure to sunlight – the major determinant of vitamin D production. People with learning disabilities are also known to have a high rate of osteoporosis and fractures. However, little is known about the vitamin D status of community-living patients with learning disabilities and, whether institutionalised or not, little information is available for patients with learning disabilities living in the UK.

Researchers from Oxford University’s Department of Psychiatry and Southern Health NHS Foundation Trust, funded by the Baily Thomas Charitable Fund, investigated potential risk factors for vitamin D deficiency in people with learning disabilities and assessed available treatments.

Some 155 individuals with learning disabilities aged 18-70 and a control group of 192 people without took part in the study. Researchers tested both groups for vitamin D deficiency and found almost twice as many people with learning disabilities were deficient compared to people in the control group (77.3% v 39.6%).

In the learning disabilities group, winter season, dark skin pigmentation, impaired mobility and obesity were independently associated with lower levels of vitamin D. Researchers concluded that vitamin D deficiency is highly prevalent in people with learning disabilities, partly because of insufficient exposure to sunlight.

Valeria Frighi, MD, who led the study, said: “Our findings partially explain why patients with intellectual disability have a high fracture risk. It is simple to test for and treat vitamin D deficiency and this should become standard care for these patients.

“A similar strategy may be required in other psychiatric populations who spend excessive time indoors and will also be at risk for fractures.”