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Incidence of osteoarthritis, osteoporosis and inflammatory musculoskeletal diseases in adults with cerebral palsy: A population-based cohort study

O'Connell, Neil E., Smith, Kimberley J., Peterson, Mark D., Ryan, Nicola, Liverani, Silvia, Anokye, Nana, Victor, Christina and Ryan, Jennifer M. (2019) Incidence of osteoarthritis, osteoporosis and inflammatory musculoskeletal diseases in adults with cerebral palsy: A population-based cohort study Bone, 125. pp. 30-35.

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Abstract

Background

People with cerebral palsy (CP) may be at increased risk of musculoskeletal conditions due to various factors including malnutrition and abnormal levels of skeletal loading. This study aimed to compare the incidence of osteoporosis, osteoarthritis and inflammatory musculoskeletal diseases between adults with and without CP.

Methods

A population based cohort study was conducted using data from the Clinical Practice Research Datalink collected between 1987 and 2015. Adults with CP were matched to adults without CP for age, sex and general practice. Cox models, stratified by matched set and adjusted for potential confounders, were fitted to compare the risk of osteoporosis, osteoarthritis and inflammatory musculoskeletal diseases.

Results

1705 adults with CP were matched to 5115 adults without CP. Adults with CP had an increased risk of osteoporosis in unadjusted (Hazard Ratio (HR) 3.67, 95% Confidence Interval (CI) 2.32 to 5.80, p ˂ 0.001) and adjusted (HR 6.19, 95% CI 3.37 to 11.39, p ˂ 0.001) analyses. No evidence of increased risk of inflammatory musculoskeletal diseases was observed in unadjusted or adjusted analyses. For osteoarthritis no evidence of increased risk was seen in the unadjusted analysis, but evidence of an increased risk was seen when the analysis was adjusted for alcohol consumption, smoking status, and mean yearly general practice (GP) visits (HR 1.54, 95% CI 1.17 to 2.02, p ˂ 0.001).

Conclusions

After accounting for potential confounding variables, we found that CP is associated with increased risk of osteoporosis and osteoarthritis. These findings provide the strongest epidemiological evidence to date for increased risk of osteoporosis and osteoarthritis in people with CP, and highlight need for clinical awareness of such conditions in this population.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Psychology
Authors :
NameEmailORCID
O'Connell, Neil E.
Smith, Kimberley J.kimberley.j.smith@surrey.ac.uk
Peterson, Mark D.
Ryan, Nicola
Liverani, Silvia
Anokye, Nana
Victor, Christina
Ryan, Jennifer M.
Date : August 2019
DOI : 10.1016/j.bone.2019.05.007
Copyright Disclaimer : © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords : Cerebral palsy; Osteoarthritis; Osteoporosis; Inflammatory musculoskeletal diseases; Incidence
Depositing User : Clive Harris
Date Deposited : 17 May 2019 08:40
Last Modified : 17 May 2019 08:47
URI: http://epubs.surrey.ac.uk/id/eprint/851852

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