Prevalence of Mental Health Disorders Among Adults With Cerebral Palsy

Whitney, Daniel G.; Warschausky, Seth; Ng, Sophia; Hurvitz, Edward A.; Kamdar, Neil; Peterson, Mark D.

doi:10.7326/m18-3420

Cited by 71 publications

(85 citation statements)

References 53 publications

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“…Studies in children without CP have shown that excess total and regional body fat is associated with cardiometabolic disease risk factors, and cardiometabolic morbidity and mortality in adulthood . Indeed, adults with CP have a markedly higher prevalence of several obesity‐related health problems compared to adults without CP, including musculoskeletal diseases, cardiometabolic diseases, mental health disorders and cardiovascular‐related death . Therefore, accurate assessment of body fat among individuals with CP during growth and development is clinically important, as it may inform preventive and rehabilitative strategies to maximize health and function as they age throughout their lifespan.…”

Section: Introductionmentioning

confidence: 99%

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

et al. 2019

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Summary The purpose of our scoping review was to determine if children and young people with cerebral palsy (CP) have elevated total or regional body fat compared to children and young people without CP. Databases (Ovid MEDLINE, Embase Ovid, CINHAL and Scopus) were systematically searched from 1 January 1993 to 7 December 2018 in order to identify articles that compared weight status, total body fat or regional body fat (eg, abdominal) between children and young people (0‐21 years) with and without CP. Extracted data included country, subject characteristics, group sample sizes and matching strategies, methods/measures for weight status/fat depot, fat depot(s) assessed and key findings. Twenty‐two studies were included. Of these, 19 studies examined total body fat; the most common method was use of anthropometrics and the more common measures were body mass index and skin‐fold thickness. Twelve studies examined at least one regional fat depot; the most common method was use of anthropometrics and the most common measure was skin‐fold thickness. Findings were inconsistent across studies. Further, among 10 studies that examined total and regional body fat depots, 8 found differences across fat depots within the same children and young people (eg, no difference in total body fat but higher abdominal fat). This review provides a summary of inconsistent findings from published studies on body fat comparisons between children and young people with vs without CP, highlights limitations for evaluating body fat for children with CP and discusses future research directions.

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Section: Introductionmentioning

confidence: 99%

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

et al. 2019

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“…To support this notion, in a previous study leveraging the same database and of the same year, the prevalence of comorbid neurodevelopmental disabilities (i.e. intellectual disabilities, autism spectrum disorders) for adults with CP was lower than expected (24). The presence of comorbid neurodevelopmental disabilities increases the medical needs and complexity of CP (25).…”

Section: Discussionmentioning

confidence: 93%

Increased prevalence of osteoarthritis in adults with cerebral palsy

French¹,

Torres²,

Whitney³

2019

J Rehabil Med

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The aim of this study was to compare the prevalence of osteoarthritis between adults with and without cerebral palsy. Data were collected from the 2016 Optum Clinformatics® Data Mart, a nationwide de-identified US insurance claims database, containing medical and pharmacy information on beneficiaries. International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (age 18+ years) with and without cerebral palsy. ICD-10 codes were also used to identify osteoarthritis. Prevalence of osteoarthritis was compared between adults with (n = 7,348) and without (n = 8.7 million) cerebral palsy, before and after adjusting for age and sex. The results showed that adults with cerebral palsy had a higher prevalence and adjusted odds of any, poly, hip, knee, and other/unspecified osteoarthritis. Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compared with men and women without cerebral palsy across all age groups. Adults with cerebral palsy had a higher prevalence of osteoarthritis compared with adults without cerebral palsy across the adult lifespan. Objective: Adults with cerebral palsy have an increased risk of developing osteoarthritis. However, little is known about the epidemiology of osteoarthritis among this vulnerable population. The objectives of this study were to compare the prevalence of osteoarthritis between adults with and without cerebral palsy, and to determine how the prevalence of osteoarthritis changes throughout adulthood for each group. Design: Data were extracted from the 2016 Optum Clinformatics® Data Mart, a nationwide database of de-identified US insurance claims, containing medical and pharmacy information on beneficiaries. Subjects: International Classification of Diseases 10 th revision (ICD-10) codes were used to identify adults (18+ years) with (n = 7,348) and without (n = 8.7 million) cerebral palsy. Methods: ICD-10 codes were used to identify osteoarthritis. Prevalence of osteoarthritis was compared between adults with and without cerebral palsy before and after adjusting for age and sex. The prevalence of any type of osteoarthritis was compared between men and women with and without cerebral palsy, stratified by the following age groups: 18-30, 31-40, 41-50, 51-60, 61-70, and > 70 years. Results: Adults with cerebral palsy had higher prevalence and adjusted odds of any, poly, hip, knee, and other/unspecified osteoarthritis (odds ratio (OR): 1.3-2.1; p < 0.001), but not hand osteoarthritis (OR: 0.86; p = 0.46). Men and women with cerebral palsy had a higher prevalence of any osteoarthritis compared with adults without cerebral palsy across all age groups (all p < 0.05). Conclusion: Privately-insured adults with cerebral palsy had a higher prevalence of osteoarthritis compared with adults without cerebral palsy across the adult lifespan.

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“…Moreover, the prevalence estimates of osteoporosis, fracture, and osteoarthritis observed in this study were markedly elevated. Recent studies leveraging private insurance claims data from 2016 found that the general population without CP of the same age group had an osteoporosis prevalence of 1.3%, fracture prevalence of 2.7% (Whitney et al, 2019b), and osteoarthritis prevalence of 7.9% (Whitney et al, 2019c). Therefore, despite the low absolute prevalence (e.g., <15%), these estimates are still much higher than what would be expected for this younger age group.…”

Section: Discussionmentioning

confidence: 99%

“…Unique DNA methylation profiles have been observed from tissue of postmenopausal women with osteoporosis (Reppe et al, 2017) and human osteoarthritic cartilage (Alvarez-Garcia et al, 2016) compared to their respective control group. Whether the causes of CP, subsequent poor psychosocial development (Whitney et al, 2019d; Whitney et al, 2018e; Whitney et al, 2019e), and race lead to DNA methylation patterns that predispose to early development of chronic diseases, including skeletal fragility and osteoarthritis, requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

Racial differences in skeletal fragility but not osteoarthritis among women and men with cerebral palsy

Whitney

2019

Bone Reports

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Background Adults with cerebral palsy (CP) have increased risk for skeletal fragility and osteoarthritis. However, racial differences in these outcomes have not been examined. Such knowledge could improve patient-specific clinical care for the prevention and management of these conditions. The purpose of this study was to determine if there were racial differences in the prevalence of osteoporosis, all-cause fracture, and osteoarthritis among young and middle-aged adults with CP. Methods Data from 2016 were extracted from a random 20% sample of the Medicare fee-for-service database. International Classification of Diseases, Tenth Revision, Clinical Modification codes were used to identify 18–64 year olds with CP, as well as osteoporosis, all-cause fracture, osteoarthritis, and neurodevelopmental and noncommunicable disease comorbidities. Results Of the 16,488 adults with CP, 13,334 were White, 2477 were Black, and 677 were Hispanic. The age-standardized prevalence of osteoporosis (women: 12.9%, 9.0%, 8.3%, respectively; men: 9.2%, 4.8%, 7.9%, respectively) and fracture (women: 7.4%, 4.2%, 9.9%; men: 6.0%, 2.3%, 6.0%) was lower for Black adults with CP compared to White adults with CP (all p < 0.005). No racial differences were observed for age-standardized prevalence of osteoarthritis (women: 13.6%, 14.4%, 9.6%; men: 10.7%, 10.4%, 12.7%). The racial differences between Black and White adults with CP remained even after adjusting for age, U.S. region, neurodevelopmental comorbidities, and several noncommunicable diseases for osteoporosis (women: OR = 0.66, 99.5% CI = 0.48–0.91; men: OR = 0.51, 99.5% CI = 0.35–0.75) and fracture (women: OR = 0.57, 99.5% CI = 0.37–0.89; men: OR = 0.39, 99.5% CI = 0.23–0.68). Conclusions Study findings suggest racial differences in skeletal fragility among young and middle-aged adults with CP, with White women and men with CP having greater risk compared to Black women and men with CP. This study found no evidence of racial differences in the prevalence of osteoarthritis.

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Prevalence of Mental Health Disorders Among Adults With Cerebral Palsy

Cited by 71 publications

References 53 publications

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

Increased prevalence of osteoarthritis in adults with cerebral palsy

Racial differences in skeletal fragility but not osteoarthritis among women and men with cerebral palsy

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