Working‐life expectancy in people with cerebral palsy in Finland

AIM: To estimate the working-life expectancy (WLE) of people with cerebral palsy (CP) compared with people without CP in Finland. METHOD: All adults with CP in the Care Register for Health Care (persons = 5320, 55% males, mean age 37 years [SD 15 years] and person-years = 48 260) were identified, with five sex-matched and birth-year-matched controls per participant with CP. Employment status and covariates were derived from population registers for the years 2006 to 2018. Multinomial logistic regression was used to estimate transition probabilities between employment and non-employment and death. WLEs for synthetic cohorts were calculated from age-specific transition probabilities using standard increment-decrement life-table techniques. RESULTS: Educational attainment was markedly lower among individuals with CP. Mild-to-moderate disability was present in 10.4%, and severe or profound intellectual disability in 7.7%. Transitions from work to non-work were twice as frequent in individuals with CP. At age 26 years, WLE was 9 years 10 months (95% confidence interval = 9 years 4 months-10 years 4 months) corresponding to 23% of total life expectancy in people with CP versus 32 years (95% confidence interval = 31 years 2 months-31 years 7 months) and 58% in those without CP. Educational and regional inequalities in WLE were more pronounced in people with CP. WLE declined steadily with age, reaching 3 years 5 months at age 45 years. INTERPRETATION: People with CP have a 20-year shorter WLE but there is substantial heterogeneity in work participation according to area of residence, subgroup, intellectual disability, and education.