Health Conditions in Adults With Cerebral Palsy: The Association With CP Subtype and Severity of Impairments

Abstract

Aim: To determine the prevalence of common health conditions in adults with cerebral palsy (CP) and to identify associations with the CP subtype or the severity of impairments.Methods: A population-based, cross-sectional study of 153 adults with CP born from 1959 to 1978 (87 males, 66 females; median age 48 years 3 months, range 37–58 years; 41% with unilateral spastic, 36% bilateral spastic, 19% dyskinetic, and 4% with ataxic CP). Data was gathered through interviews, physical assessments, and medical record reviews.Results: The most common health conditions in adults with CP were pain 65%, upper gastrointestinal disorders 33%, dysphagia 29%, epilepsy 29%, and depression 27%. Cerebral palsy subtype was significantly associated with the presence of pain (p = 0.029), gastrointestinal (p < 0.001), and respiratory disorders (p = 0.006). A more severe physical impairment was associated with a higher prevalence of gastrointestinal disorders (p < 0.001), respiratory disorders (p < 0.001), and pressure ulcers (p < 0.001). Intellectual disability was associated with a higher prevalence of gastrointestinal disorders (p < 0.001), pneumonia (p = 0.001) epilepsy (p = 0.001), and pressure ulcers (p < 0.001), but with a lower prevalence of pain (p < 0.004) and hypertension (p = 0.043).Conclusion: The prevalence of several common health conditions is related to the CP subtype and severity of impairments, indicating that CP plays a role in the development of these health conditions. Follow-up of adults with CP needs to include not only impairments, but general health as well. Increased attention directed toward signs of gastrointestinal and respiratory disorders in individuals with either dyskinetic CP, gross motor function classification system (GMFCS) levels IV–V, or intellectual disability, is recommended.

Psychiatric symptoms in adult patients with cerebral palsy: A cohort study

“…This ratio was less skewed when considering anxiety as it occurred with a 3–2 ratio in patients with ID. This is similar to McMorris et al ( 11 ), Jonsson et al ( 16 ), and Whitney et al ( 9 ) who showed a prevalence of psychotic disorders in patients with CP and ID and a prevalence of anxiety disorders in patients with only CP.…”

“…In addition, Van Gorp et al ( 15 ) showed that patients with GMFCS I had fewer depressive symptoms when compared to the age-matched reference population. By contrast, Jonsson et al ( 16 ) when compared different levels of GMFCS and CFCS found no significant differences in psychiatric symptoms, depression, and anxiety. Our results, therefore, are in agreement with those that showed an increased risk of psychiatric disorders when a severe motor impairment is present.…”

“…For example, Van der Sloot ( 12 ) found an association of the level of motor impairment measured with the Gross Motor Function Classification System—Expanded & Revised (GMFCS-E&R) ( 18 ) but no difference based on sex. Other studies found that the occurrence of other impairments, such as epilepsy, gastrointestinal, or respiratory disorders, seemed to be unrelated ( 13 , 16 ) while the influence of a concurrent ID on mental health remained controversial ( 11 , 13 ). Whitney et al ( 17 , 19 ) found that several factors, as sleep disorders, pain and fatigue, were associated with different prevalence of mental health disorders.…”

Prevalence and incidence of chronic conditions among adults with cerebral palsy: A systematic review and meta‐analysis

“…Prevalence of diabetes (type not specified) was 9.6% (95% CI = 6.9%-12.6%; I 2 = 99.3%, p < 0.01; n = 11 723 out of 71 815; 15 studies). 28,[31][32][33][34][37][38][39][40][41][42][43][44][45][46] Age-adjusted prevalence of diabetes reported in one study was 9.2%. 47 The prevalence of diabetes among non-ambulatory individuals with CP in two studies was 7.0% and 8.6%.…”

“…The prevalence of pressure ulcers reported by two studies was 7.8% and 9.2%. 36,37 The prevalence of pressure ulcers was 1.8% among ambulatory individuals and 27.9% among non-ambulatory individuals with CP. 33 The prevalence of pressure ulcers was 35.3% among people with intellectual disability and 1.7% among people without intellectual disability.…”