Noncommunicable disease and multimorbidity in young adults with cerebral palsy

Daniel G Whitney,1 Edward A Hurvitz,1 Jennifer M Ryan,2,3 Maureen J Devlin,4 Michelle S Caird,5 Zachary P French,1 Elie C Ellenberg,1 Mark D Peterson1 1Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; 2Department of Epidemiology and P...

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Main Authors: Whitney DG, Hurvitz EA, Ryan JM, Devlin MJ, Caird MS, French ZP, Ellenberg EC, Peterson MD
Format: Article
Language:English
Published: Dove Medical Press 2018-05-01
Series:Clinical Epidemiology
Subjects:
Online Access:https://www.dovepress.com/noncommunicable-disease-and-multimorbidity-in-young-adults-with-cerebr-peer-reviewed-article-CLEP
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author Whitney DG
Hurvitz EA
Ryan JM
Devlin MJ
Caird MS
French ZP
Ellenberg EC
Peterson MD
author_facet Whitney DG
Hurvitz EA
Ryan JM
Devlin MJ
Caird MS
French ZP
Ellenberg EC
Peterson MD
author_sort Whitney DG
collection DOAJ
description Daniel G Whitney,1 Edward A Hurvitz,1 Jennifer M Ryan,2,3 Maureen J Devlin,4 Michelle S Caird,5 Zachary P French,1 Elie C Ellenberg,1 Mark D Peterson1 1Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; 2Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; 3Department of Clinical Sciences, Brunel University London, Uxbridge, UK; 4Department of Anthropology, University of Michigan, Ann Arbor, MI, USA; 5Department of Orthopedic Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Purpose: Individuals with cerebral palsy (CP) are at increased risk for frailty and chronic disease due to factors experienced throughout the lifespan, such as excessive sedentary behaviors and malnutrition. However, little is known about noncommunicable diseases (NCDs) and multimorbidity profiles in young adults with CP. The study objective was to compare NCD and multimorbidity profiles between young adults with and without CP.Methods: A clinic-based sample of adults (18–30 years) with (n=452) and without (n=448) CP was examined at the University of Michigan Medical Center. The prevalence and predictors of 13 NCDs were evaluated, including existing diagnoses or historical record of musculoskeletal, cardiometabolic, and pulmonary morbidities. The level of motor impairment was determined by the Gross Motor Function Classification System (GMFCS) and stratified by less vs more severe motor impairment (GMFCS I–III vs IV–V). Logistic regression was used to determine the odds of NCD morbidity and multimorbidity in adults with CP compared to adults without CP, and for GMFCS IV–V compared to GMFCS I–III in those with CP, after adjusting for age, sex, body mass index, and smoking.Results: Adults with CP had a higher prevalence of osteopenia, osteoporosis, hypertension, myocardial infarction, hyperlipidemia, asthma, and multimorbidity compared to adults without CP, and higher odds of musculoskeletal (odds ratio [OR]: 6.97) and cardiometabolic morbidity (OR: 1.98), and multimorbidity (OR: 2.67). Adults with CP with GMFCS levels IV–V had 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) compared to GMFCS I–III.Conclusion: Young adults with CP have a higher prevalence of chronic NCDs and multimorbidity compared to young adults without CP, which is pronounced in those with more severe motor impairment. These findings reiterate the importance of early screening for prevention of NCDs in CP. Keywords: cerebral palsy, noncommunicable disease, multimorbidity, osteoporosis, osteoarthritis, cardiovascular disease, diabetes, pulmonary disease 
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spelling doaj.art-6a4595d7f46e45b3897a06f069b229de2022-12-22T03:44:40ZengDove Medical PressClinical Epidemiology1179-13492018-05-01Volume 1051151938061Noncommunicable disease and multimorbidity in young adults with cerebral palsyWhitney DGHurvitz EARyan JMDevlin MJCaird MSFrench ZPEllenberg ECPeterson MDDaniel G Whitney,1 Edward A Hurvitz,1 Jennifer M Ryan,2,3 Maureen J Devlin,4 Michelle S Caird,5 Zachary P French,1 Elie C Ellenberg,1 Mark D Peterson1 1Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; 2Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; 3Department of Clinical Sciences, Brunel University London, Uxbridge, UK; 4Department of Anthropology, University of Michigan, Ann Arbor, MI, USA; 5Department of Orthopedic Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA Purpose: Individuals with cerebral palsy (CP) are at increased risk for frailty and chronic disease due to factors experienced throughout the lifespan, such as excessive sedentary behaviors and malnutrition. However, little is known about noncommunicable diseases (NCDs) and multimorbidity profiles in young adults with CP. The study objective was to compare NCD and multimorbidity profiles between young adults with and without CP.Methods: A clinic-based sample of adults (18–30 years) with (n=452) and without (n=448) CP was examined at the University of Michigan Medical Center. The prevalence and predictors of 13 NCDs were evaluated, including existing diagnoses or historical record of musculoskeletal, cardiometabolic, and pulmonary morbidities. The level of motor impairment was determined by the Gross Motor Function Classification System (GMFCS) and stratified by less vs more severe motor impairment (GMFCS I–III vs IV–V). Logistic regression was used to determine the odds of NCD morbidity and multimorbidity in adults with CP compared to adults without CP, and for GMFCS IV–V compared to GMFCS I–III in those with CP, after adjusting for age, sex, body mass index, and smoking.Results: Adults with CP had a higher prevalence of osteopenia, osteoporosis, hypertension, myocardial infarction, hyperlipidemia, asthma, and multimorbidity compared to adults without CP, and higher odds of musculoskeletal (odds ratio [OR]: 6.97) and cardiometabolic morbidity (OR: 1.98), and multimorbidity (OR: 2.67). Adults with CP with GMFCS levels IV–V had 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) compared to GMFCS I–III.Conclusion: Young adults with CP have a higher prevalence of chronic NCDs and multimorbidity compared to young adults without CP, which is pronounced in those with more severe motor impairment. These findings reiterate the importance of early screening for prevention of NCDs in CP. Keywords: cerebral palsy, noncommunicable disease, multimorbidity, osteoporosis, osteoarthritis, cardiovascular disease, diabetes, pulmonary disease https://www.dovepress.com/noncommunicable-disease-and-multimorbidity-in-young-adults-with-cerebr-peer-reviewed-article-CLEPCerebral palsynoncommunicable diseasemultimorbidity
spellingShingle Whitney DG
Hurvitz EA
Ryan JM
Devlin MJ
Caird MS
French ZP
Ellenberg EC
Peterson MD
Noncommunicable disease and multimorbidity in young adults with cerebral palsy
Clinical Epidemiology
Cerebral palsy
noncommunicable disease
multimorbidity
title Noncommunicable disease and multimorbidity in young adults with cerebral palsy
title_full Noncommunicable disease and multimorbidity in young adults with cerebral palsy
title_fullStr Noncommunicable disease and multimorbidity in young adults with cerebral palsy
title_full_unstemmed Noncommunicable disease and multimorbidity in young adults with cerebral palsy
title_short Noncommunicable disease and multimorbidity in young adults with cerebral palsy
title_sort noncommunicable disease and multimorbidity in young adults with cerebral palsy
topic Cerebral palsy
noncommunicable disease
multimorbidity
url https://www.dovepress.com/noncommunicable-disease-and-multimorbidity-in-young-adults-with-cerebr-peer-reviewed-article-CLEP
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