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U-M researchers find adults with cerebral palsy more likely to have chronic health conditions

ANN ARBOR, Mich. – A new study from the University of Michigan finds adults with cerebral palsy are more likely to have secondary chronic health conditions, such as diabetes and high blood pressure, than adults without cerebral palsy.

The findings raise questions about how to prevent or reduce these conditions among the high-risk population.

Cerebral palsy is a pediatric neurodevelopmental disorder caused by damage to the brain, generally before birth. It results in a wide range of physical and developmental problems such as uncontrollable movements or muscular activity, loss of muscle tone and strength, and weakened reflexes and balance, in addition to a wide-range of medical and cognitive difficulties such as swallowing, seizures, and orthopedic abnormalities.

“As a father of a child with cerebral palsy, I’m dedicated to improving the scientific evidence and clinical care of this growing population,” says lead author Mark Peterson, Ph.D., M.S., assistant professor of physical medicine and rehabilitation at the University of Michigan.

Peterson
Lead author
Mark Peterson, Ph.D., M.S.

“Unfortunately, it’s still not fully understood how to best care for individuals with cerebral palsy as they transition into and throughout adulthood. We sought to determine whether adults with cerebral palsy suffer from secondary chronic health conditions more frequently, and how that can affect future medical care for this population,” he adds.

The new study, published Dec. 1 in JAMA, measured the prevalence estimates of eight, lifestyle-related chronic health conditions in both adults with cerebral palsy and those without.

The research team used data from the Medical Expenditure Panel Survey, a set of large-scale surveys conducted by the Agency for Healthcare Research and Quality to find and collect data on health care services, usage and costs. The study included 207,615 adults, ages 18 or older, with 1,015 of those having cerebral palsy.

The team determined adults with cerebral palsy were between two and five times more likely to have these chronic health conditions than adults without cerebral palsy. After adjusting for age, numerous sociodemographic factors, body mass index, physical activity, and degree of disability, they still found the prevalence of chronic health conditions significantly greater in adults with cerebral palsy.

Specifically, they found:

  • Diabetes, 9.2 percent in adults with cerebral palsy versus 6.3 percent in adults without
  • Asthma, 20.7 percent vs. 9.4 percent
  • Hypertension, 30 percent vs. 22.1 percent
  • Other cardiovascular conditions, 15.1 percent vs.9.1 percent
  • Stroke, 4.6 percent vs. 2.3 percent
  • Emphysema, 3.8 percent vs. 1.4 percent
  • Joint pain, 43.6 percent vs. 28 percent
  • Arthritis, 31.4 percent vs. 17.4 percent

They also found age, sex, obesity, degree of physical disability and physical inactivity to be significantly associated with each of the chronic conditions.

Peterson says the results indicate chronic health conditions are much more common in adults with cerebral palsy and should raise questions among fellow health care providers.

“Because cerebral palsy results in accelerated losses of mobility with age, individuals tend to experience more fatigue and have greater muscle and joint pain over time. We found physical inactivity and immobility were strongly associated with these chronic health conditions,” Peterson says.

“Therefore, we need to strongly consider how these health complications could further impact this population, and how we can prevent or reduce these conditions among individuals with cerebral palsy through their lifespan.”

Authors: In addition to Peterson, the study’s authors include Edward Hurvitz, M.D., chair of the U-M Department of Physical Medicine and Rehabilitation, Elham Mahmoudi, Ph.D., of the U-M Department of Surgery, and Jennifer Ryan, Ph.D., of the Institute of Environment, Health and Societies at Brunel University London.

Funding: Funding for the study came from the National Institutes of Health (grant 1KO1 HD074706).

Disclosures: none.

Reference: JAMA, http://dx.doi.org/10.1001/jama.2015.11025.

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