Young Adults with Cerebral Palsy at Higher Risk for Certain Chronic Conditions
Young adults with cerebral palsy have a greater risk of developing certain chronic conditions, especially those with a more severe motor impairment, according to researchers.
Factors experienced throughout the lifespan of cerebral palsy patients, such as excessive sedentary behaviors and malnutrition, increase the risk of developing chronic noncommunicable diseases (NCDs, a term used to refer to diseases that are noninfectious and non-transmittable, such as cardiovascular diseases, cancer, and diabetes) at an earlier age than the general population.
Clinical care has been extensively studied for cerebral palsy patients at younger ages (childhood and adolescence), but few studies have focused on progression to early adult years. There is a need to understand diseases associated with aging among these patients.
The study, “Noncommunicable disease and multimorbidity in young adults with cerebral palsy,” which was published in the journal Clinical Epidemiology, assessed NCDs and associated risk factors in young adults with cerebral palsy.
The study included people ages 18 to 30, 452 of whom had been diagnosed with cerebral palsy and 448 of them healthy (used as controls).
Patients were classified according to their level of motor impairment using a standard system known as the Gross Motor Function Classification System (GMFCS).
Based on this classification, they were placed in one of two categories: those with less motor impairment (51%) and those with greater motor impairment (49%).
Researchers evaluated the prevalence of 13 NCDs, which they placed into three categories: musculoskeletal conditions (osteopenia and osteoporosis, osteoarthritis, and rheumatoid arthritis); cardiometabolic conditions (stroke, hypertension, other cardiovascular problems, coronary artery disease, impaired glucose tolerance or type 2 diabetes, myocardial infarction, and hyperlipidemia); and pulmonary morbidity (asthma, pulmonary embolism, and emphysema).
Statistical analyses showed that compared to healthy controls, cerebral palsy patients had a greater chance of developing musculoskeletal conditions and a higher prevalence of osteopenia/osteoporosis.
In these patients, musculoskeletal morbidity was associated with age, being underweight, and smoking.
And patients with greater motor impairment had a higher risk of developing musculoskeletal conditions and a higher prevalence of osteopenia/osteoporosis and osteoarthritis compared to those with less motor impairment.
The same trend was observed in cardiometabolic morbidity, with CP patients having a greater risk of developing hypertension, heart attack, and high cholesterol.
Patients with greater motor impairment also had a higher risk of cardiometabolic condtions and had a higher prevalence of hypertension and other cardiovascular problems.
However, only obesity was found to be significantly associated with cardiometabolic morbidity.
Patients with cerebral palsy also had a higher prevalence of asthma, and those with greater motor impairment had a higher prevalence of pulmonary embolism.
Adults with CP had a higher prevalence of multimorbidity — defined as the presence of two or more chronic medical conditions — compared to those without cerebral palsy.
There were also higher odds of multimorbidity among patients with a higher degree of motor impairment and, among factors associated with multimorbidity (underweight, obesity, and smoking status), only obesity was significantly associated with multimorbidity in individuals with cerebral palsy.
“The principal findings of this study are that young adults with CP have a higher prevalence of NCDs relating to musculoskeletal, cardiometabolic, and pulmonary systems compared to the general population of young adults without CP,” researchers wrote.
“Our findings highlight the importance of clinical screening for NCD clustering in persons with CP as early as adolescence or young adulthood, and may prompt early behavioral interventions for NCD prevention in this population,” they added.
