Prevalence of and risk factors for osteoporosis and fragility fracture in adults with cerebral palsy: A systematic review
- Published
- Tuesday, January 21, 2025 - 12:00 PM
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Adults with cerebral palsy (CP) may experience bone fractures, or osteoporosis (bone weakness and fragile bones). However the proportion of adults with CP who experience these conditions, and any risk factors for developing these conditions were not well known. Using a systematic research method, this study by researchers in Australia, the USA and Canada reviewed the published research that investigated these topics.
Information from 17 included studies suggested that the proportion of individuals with osteoporosis was about 5% in a general adult population with CP, but up to 43% in those attending CP-specific outpatient clinics. Similarly, the proportion of individuals who experienced a fragility fracture (mostly occurring in the legs) was 5.5% overall, but up to 38% in adults attending a CP-specific outpatient clinic (likely due to additional patient complexity). This proportion was higher in people who were not walking (higher GMFCS levels). The proportion of adults with CP experiencing a fracture and osteoporosis was also associated with increasing age and being female.
Information from 16 included studies confirmed risk factors for the development of poor bone health included reduced functional mobility (higher GMFCS Levels), nutritional deficiencies, and using anti-convulsant medication. Other risk factors for poor bone health that may require further investigation include hypogonadism, the type of CP (e.g. dyskinetic, spastic), and ethnicity.
A multi-disciplinary approach is required to address these modifiable risk factors from childhood to first allow adequate development of bone density, and then maintenance of bone mass throughout adulthood.
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