Age and sex-specific risk in fractures with Down syndrome in a retrospective case-control study from Germany.

Autor: Krieg S; Department of Inclusive Medicine, University Hospital Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany., Krieg A; Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany., Kostev K; Epidemiology, IQVIA, Frankfurt, Germany.
Jazyk: angličtina
Zdroj: Journal of intellectual disability research : JIDR [J Intellect Disabil Res] 2024 Dec; Vol. 68 (12), pp. 1374-1385. Date of Electronic Publication: 2024 Aug 25.
DOI: 10.1111/jir.13183
Abstrakt: Background: The increasing life expectancy of individuals with Down syndrome has led to a growing awareness of mid- and late-life conditions.
Methods: Based on the Disease Analyser database (IQVIA), this retrospective cohort study compared adults ≥18 years of age with Down syndrome (ICD-10: Q90) in general practices in Germany with a propensity score-matched cohort without Down syndrome. The outcome was the first diagnosis of a fracture within 5 years of the index date. The cumulative incidence of fractures over a 5-year period was presented using Kaplan-Meier curves. Univariable Cox regression analyses by age group and sex were performed to assess the association between Down syndrome and fractures.
Results: A total of 2547 individuals with Down syndrome and 12 735 individuals without Down syndrome were included in the study. A significantly higher cumulative fracture incidence within 5 years was observed in the age group 51-60 years (9.3% Down syndrome vs. 4.8% without Down syndrome, P = 0.003) as well as in the age group >60 years (20.3% Down syndrome vs. 8.6% without Down syndrome, P < 0.001) compared with the cohort without Down syndrome. Regression analysis showed a significant association between Down syndrome and fracture risk in women with Down syndrome aged 51-60 years (hazard ratio [HR] = 1.60; 95% confidence interval [CI]: 1.13-2.26), and in those aged 51-60 years (HR = 2.08; 95% CI: 1.27-3.41) and >60 years (HR = 2.98; 95% CI: 1.87-4.73)), but not in men. When comparing fractures in individuals with and without Down syndrome, shoulder and arm fractures were most common in the Down syndrome cohort.
Conclusion: The results of our study indicate a positive association between individuals with Down syndrome and subsequent fractures in women and those aged >50 years. Prevention of falls appears to be particularly important in these populations. However, future studies should clarify the extent to which socio-economic factors, such as housing, play a role in this context.
(© 2024 The Author(s). Journal of Intellectual Disability Research published by John Wiley & Sons and MENCAP.)
Databáze: MEDLINE
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