People with disabilities are at risk of osteoporotic fractures: a population-based study in South Korea.

Background: Osteoporotic fractures are a major public concern as a serious, fatal condition. We aimed to investigate the differences in the incidence and types of osteoporotic fractures between people with and without disabilities, including both mental and physical disabilities.

Methods: This is a serial cross-sectional study using the National Disability Registration and National Health Insurance claims data. After excluding individual with Paget's disease and cancer that damages bone, we analyzed trends and associated factors of osteoporotic fractures between 2008 and 2017.

Results: The age-standardized incidence rate (ASIR) of osteoporotic fractures was higher in the disabled than in the non-disabled for 10 years (41.3 and 24.0 per 10 000 persons, respectively, in 2017). Vertebral fractures were the most common. However, the incidence of non-vertebral fractures was about twice as high in the disabled as in the non-disabled. In multivariate analysis, the highest odds ratios were observed for epilepsy (OR = 3.80; 95% confidence intervals = 2.40-5.99), liver disease (OR = 2.38), and intellectual disability (OR = 1.95) in men and for epilepsy (OR = 3.19), liver (OR = 1.64), and respiratory (OR = 1.49) disease in women.

Conclusion: Given the preventability and high incidence of fracture in disabled people, health systems should be designed to ensure timely and appropriate prevention and intervention for disabled people.