Prevalence of and risk factors for osteoporosis and fragility fracture in adults with cerebral palsy: A systematic review

Abstract

Individuals with cerebral palsy (CP) are living longer and experience new complications of their CP associated with ageing. Even those with the most severe impairments are living to young adulthood. If they survive to age 25 years, their remaining life expectancy is another 30 years. Several epidemiological studies have identified two main disease processes highly prevalent in adults with CP, namely bone fragility and cardiometabolic disease. This study reviews how common weak bones and fractures are in adults with CP, and what factors increase the risk of these conditions.

Researchers searched multiple medical databases for studies on adults with CP. They looked for studies that reported on the prevalence (how common) and incidence (new cases) of these bone conditions, as well as risk factors.

Out of 303 studies, 17 were relevant for prevalence and incidence, and 16 out of 663 for risk factors. Osteoporosis was found in 5% of the general adult CP population, but this increased to 43% in those attending clinics. Those attending clinics had poorer mobility and more complex medical issues. Fragility fractures were found in 5.5% of adults overall, but up to 38% in clinic patients. Key risk factors included limited mobility, poor nutrition, and use of anticonvulsant medications.