Cardiovascular, Respiratory Diseases May Increase Risk of Death in Adults with Cerebral Palsy, Study Suggests

Adults with cerebral palsy in England may have an increased risk of death due to cardiovascular or respiratory system diseases, a study suggests.

The study, “Mortality due to cardiovascular disease, respiratory disease, and cancer in adults with cerebral palsy,” was published in the journal Developmental Medicine & Child Neurology.

Advances in medical care have improved survival in children with cerebral palsy, and most patients are now expected to live to adulthood.

Since the ’80s, however, the mortality rate of adults with cerebral palsy has increased 1.7 percent every year, compared with the general population. Nonetheless, there is no extensive study about the causes of death among adults with cerebral palsy.

Twenty years ago, University of California researchers investigated mortality in a California population of 45,292 individuals with cerebral palsy, 4,028 of whom died during the study period. Scientists reported that the studied sample had an increased risk of death due to ischemic heart disease, cerebrovascular disease, cancer, pneumonia, chronic obstructive pulmonary disease, and diseases of the digestive system.

They also added that similar to the general population, diseases of the circulatory system were the leading cause of mortality among the patients with cerebral palsy. However, studies outside the U.S. suggest that respiratory diseases are the leading cause of death.

“Cardiovascular disease, chronic respiratory disease, and cancer are leading causes of death worldwide,” researchers wrote. The potential causal pathway between [cerebral palsy] and these diseases has not been explored. However, physical inactivity is a shared risk factor for these diseases,” they said.

Researchers from Brunel University London, in collaboration with other institutions, have now compared mortality rates for cardiovascular disease, cancer, and respiratory disease between adults with cerebral palsy and the general population.

They identified 958 adults in England with a diagnosis of cerebral palsy (52.5% men, 47.5% women) using the Clinical Practice Research Datalink, a primary care data set that holds electronic health records from 674 general practices across all regions of the U.K.

Median age at the start of follow‐up was 31 years, and each patient was followed for an average of seven years and two months.

Of these patients, 142 (15%) died during the study period.

“Overall, 26.8 percent of deaths [38 subjects] were due to diseases of the respiratory system, 19.7 percent of deaths [28 subjects] were due to diseases of the circulatory system, and 9.2 percent of deaths [13 subjects] were due to malignant neoplasms,” the researchers wrote.

Results revealed adults with cerebral palsy in England have a 14 times higher risk of mortality due to respiratory diseases and are three times more likely to die from diseases of the circulatory system, compared with the general population.

In terms of specific diseases of the circulatory system, patients had an increased risk of cerebrovascular disease, i.e., a disease affecting blood flow through the brain. Death by ischemic heart disease was 1.8 times higher in the cerebral palsy sample than in the general population, but no statistical significance was attained.

No increased risk of death due to cancer was observed.

“The increased risk of cardiovascular- and respiratory-related mortality in people with [cerebral palsy] may be partly explained by delays in diagnosis and treatment of existing disease. However, as no study has examined the management of these conditions in people with [cerebral palsy], future research is urgently required to explore this further,” the researchers concluded.