Risk of early- and late-onset Alzheimer disease and related dementia in adults with cerebral palsy

Dev Med Child Neurol. 2022 Mar;64(3):372-378. doi: 10.1111/dmcn.15044. Epub 2021 Sep 8.

Abstract

Aim: To examine the risk of Alzheimer disease and related dementia (ADRD) among adults with cerebral palsy (CP).

Method: Using administrative insurance claims data for 2007 to 2017 in the USA, we identified adults (45y or older) with a diagnosis of CP (n=5176). Adults without a diagnosis of CP were included as a typically developing comparison group (n=1 119 131). Using age, sex, ethnicity, other demographic variables, and a set of chronic morbidities, we propensity-matched individuals with and without CP (n=5038). Cox survival models were used to estimate ADRD risk within a 3-year follow up.

Results: The unadjusted incidence of ADRD was 9 and 2.4 times higher among cohorts of adults 45 to 64 years (1.8%) and 65 years and older (4.8%) with CP than the respective unmatched individuals without CP (0.2% and 2.0% among 45-64y and 65y or older respectively). Fully adjusted survival models indicated that adults with CP had a greater hazard for ADRD (among 45-64y: unmatched hazard ratio 7.48 [95% confidence interval {CI} 6.05-9.25], matched hazard ratio 4.73 [95% CI 2.72-8.29]; among 65y or older: unmatched hazard ratio 2.21 [95% CI 1.95-2.51], matched hazard ratio 1.73 [1.39-2.15]).

Interpretation: Clinical guidelines for early screening of cognitive function among individuals with CP need updating, and preventative and/or therapeutic services should be used to reduce the risk of ADRD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Alzheimer Disease / epidemiology
  • Cerebral Palsy / epidemiology*
  • Comorbidity
  • Dementia / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • United States / epidemiology