Noncommunicable disease among adults with cerebral palsy

Abstract

ObjectiveTo compare the incidence of noncommunicable diseases between adults with and without cerebral palsy (CP).MethodsA cohort study was conducted using primary care data from the Clinical Practice Research Datalink. Cox models, stratified by matched set and adjusted for potential confounders, were fitted to compare the risk of any noncommunicable disease, cancer, cardiovascular disease, type 2 diabetes mellitus, and respiratory disease between adults with and without CP.ResultsThe analysis included 1,705 adults with CP and 5,115 age-, sex-, and general practice–matched adults without CP. There was evidence from adjusted analyses that adults with CP had 75% increased risk of developing any noncommunicable disease compared to adults without CP (hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.58–1.94). Specifically, they had increased risk of cardiovascular disease (HR 1.76, 95% CI 1.48–2.11) and respiratory disease (HR 2.61, 95% CI 2.14–3.19). There was no evidence of increased risk of cancer or type 2 diabetes mellitus.ConclusionsAdults with CP had increased risk of noncommunicable disease, specifically cardiovascular and respiratory disease. These findings highlight the need for clinical vigilance regarding identification of noncommunicable disease in people with CP and further research into the etiology and management of noncommunicable disease in this population.

Why individuals with cerebral palsy are at higher risk for respiratory complications from COVID-19

“…In one registry review, 58% of children with CP had a daily cough or wheeze, 10% had obstructive sleep apnea, 40% had a cough with drinking, and 20% had abnormalities on clinical pulmonary exam [16]. Furthermore, adults with CP have a greater risk of respiratory disease than adults in the general population [17,18]. The DIAm plays a critical role in reducing susceptibility to respiratory infections in two ways: 1) during the pharyngeal phase of swallowing, the DIAm generates a large negative intrathoracic pressure necessary to propel a food bolus through the pharynx and into the esophagus, with failure resulting in aspiration; and 2) coughing and sneezing, where the DIAm contributes to increased intraabdominal pressure necessary to expel aspirates and phlegm from the airway [11,[19][20][21].…”

Health service use among adults with cerebral palsy: a mixed methods systematic review protocol

“… 10 Many adults with CP experience secondary conditions with age that require intervention and support from clinicians working across multiple health and social care disciplines. 12 Previous research has demonstrated that young people with CP experience challenges in accessing health services, as they move from child to adult health services. 19 21 56–58 Therefore, a review of health service use among adults with CP is required in order to direct research efforts and inform service provision.…”

“…For instance, adults with CP experience increased risk of arthritis, stroke, heart failure, ischaemic heart disease, chronic respiratory disease and mental health disorders compared with adults without CP. [11][12][13][14] Studies have also reported increased fatigue, incidence of falls, pain and a decline in mobility, as people with CP move into adulthood. [15][16][17] Therefore, adults with CP may require extensive health services.…”

Ictus no Comunicable en un Adulto Joven Con Parálisis Cerebral Portador Del Genotipo MTHFR Variante C677T Homocigótica.

“…Aunque la PC no es una condición progresiva, sin embargo, al menos una cuarta parte de los adultos jóvenes informan que su capacidad para caminar empeora en algún momento de su enfermedad. 3 Por otra parte, se ha visto que el ictus puede ser una enfermedad no comunicable (ENC) entre los adultos con PC, 3 lo que pudo ocurrir en nuestro caso. Sabemos que existe un incremento del riesgo de ictus en los adultos con PC comparado con los adultos sin PC, aunque los mecanismos subyacentes no están dilucidados.…”

“…Otros factores potenciales que impulsan la asociación entre la PC y el aumento de la tasa de ENC pueden incluir la inactividad física y el manejo inadecuado de los factores de riesgo de ENC como la hiperlipidemia. 3 Los estudios de poblaciones sin discapacidad que Figura 2. Doppler carotídeo-vertebral: Ligero aumento difuso del espesor de la íntima-media a lo largo de los ejes carotídeos común e interno.…”