Neurodevelopmental disabilities double the risk of fracture

  • Bone

  • International Clinical Digest
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Takeaway

  • Adults with neurodevelopmental disabilities (NDDs) have approximately double the risk of fracture vs adults without NDDs.
  • Increasing comorbidity of NDDs is associated with even higher prevalence of fractures at most anatomical locations.

Why this matters

  • Findings from this neglected population suggest the need for earlier screening and preventive interventions for musculoskeletal frailty.

Study design

  • Retrospective cohort of 3 common NDDs: intellectual disabilities (n=69,456), autism spectrum disorders (n=21,844), and cerebral palsy (n=29,255).
  • Control group was adults without NDDs (n=8.7 million).
  • Because risk of fracture increases with age, all prevalence figures were age-standardised.
  • Funding: University of Michigan.

Key results

  • NDD adults had approximately double the rate of any fracture vs non-NDD adults:
    • Women: 8.3% with intellectual disabilities, 8.1% with autism spectrum disorders, and 8.5% for cerebral palsy vs 3.5% with non-NDD.
    • Men: 6.6% with intellectual disabilities, 5.9% with autism spectrum disorders, and 6.7% for cerebral palsy vs 3.0% with non-NDD.
  • Increasing comorbidity of NDDs was associated with higher prevalence of any fracture: 1 NDD (women, 7.7%; men, 5.7%), 2 NDDs (9.4%; 7.2%, respectively), 3 NDDs (11.3%; 13.7%, respectively).

Limitations

  • Reliance on administrative data claims.