Elevated fracture risk for adults with neurodevelopmental disabilities

Area of Science:

• Orthopedics
• Public Health
• Neuroscience

Background:

• Fractures represent a significant health burden, accelerating aging and incurring substantial economic costs.
• Adults with neurodevelopmental disabilities (NDDs) may face increased fracture susceptibility at younger ages.
• Limited research exists on fracture burden in underserved populations with NDDs.

Purpose of the Study:

• To determine the sex-stratified prevalence of all-cause fractures in adults with NDDs compared to those without.
• To investigate if NDD comorbidity is associated with an increased risk of fracture.

Main Methods:

• Utilized 2016 data from private insurance and Medicare fee-for-service.
• Identified adults with NDDs (intellectual disabilities, autism spectrum disorders, cerebral palsy) using ICD-10-CM codes.
• Compared age-standardized fracture prevalence between NDD and non-NDD groups, and across varying levels of NDD comorbidity.

Main Results:

• Adults with intellectual disabilities, autism spectrum disorders, and cerebral palsy showed higher fracture prevalence than the general population.
• Women with NDDs had fracture rates ranging from 8.1% to 8.5%, compared to 3.5% in women without NDDs.
• Men with NDDs had fracture rates from 5.9% to 6.7%, versus 3.0% in men without NDDs.
• Increasing NDD comorbidity correlated with higher fracture prevalence in both sexes, reaching 11.3% (women) and 13.7% (men) with three NDDs.

Conclusions:

• Adults with NDDs exhibit an elevated fracture prevalence compared to their non-NDD counterparts.
• Fracture risk escalates with a higher number of comorbid NDD conditions across most anatomical sites.
• Findings underscore the necessity for early screening and preventive measures for musculoskeletal health in adults with NDDs.