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

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.