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Noncommunicable disease and multimorbidity in young adults with cerebral palsy

Clinical Epidemiology May 10, 2018

Whitney DG, et al. - Excessive sedentary behaviors and malnutrition, among other lifestyle factors can increase the risk of frailty and chronic disease in patients with cerebral palsy (CP), so researchers compared noncommunicable diseases (NCDs) and multimorbidity profiles in young adults both with and without CP. A higher prevalence of chronic NCDs and multimorbidity was seen among young adults with CP compared to young adults without CP. This appeared to be more prevalent in those with more severe motor impairment. The importance of early screening for prevention of NCDs in CP is reinforced by the data.

Methods

  • At the University of Michigan Medical Center, experts analyzed adults (18-30 years) with (n=452) and without (n=448) CP.
  • An evaluation was performed of the prevalence and predictors of 13 NCDs, with the inclusion of existing diagnoses or historical record of musculoskeletal, cardiometabolic, and pulmonary morbidities.
  • Using the Gross Motor Function Classification System (GMFCS), the level of motor impairment was determined and stratified by less vs more severe motor impairment (GMFCS I-III vs IV-V).
  • After adjusting for age, sex, body mass index, and smoking, logistic regression was utilized in obtaining the odds of NCD morbidity and multimorbidity in adults with CP vs adults without CP, and for GMFCS IV-V vs GMFCS I-III in those with CP.

Results

  • Data unveiled a higher prevalence of osteopenia, osteoporosis, hypertension, myocardial infarction, hyperlipidemia, asthma, and multimorbidity among adults with CP vs adults without CP.
  • Adults with CP also presented with higher odds of musculoskeletal (odds ratio [OR]: 6.97) and cardiometabolic morbidity (OR: 1.98), and multimorbidity (OR: 2.67).
  • A higher prevalence of osteopenia/osteoporosis, osteoarthritis, hypertension, other cardiovascular conditions, pulmonary embolism, and multimorbidity, and higher odds of musculoskeletal (OR: 3.41), cardiometabolic (OR: 2.05), pulmonary morbidity (OR: 1.42), and multimorbidity (OR: 3.45) was seen in adults with CP with GMFCS levels IV-V vs those with GMFCS I-III.
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