Preventable comorbidities common in cerebral palsy patients

By Eleanor McDermid, Senior medwireNews Reporter

Medical comorbidities are common in patients with cerebral palsy and may impact on their mobility, report researchers.

These health problems include conditions such as hypertension and obesity, “raising important questions about preventable health complications in this population”, say Mark Peterson (University of Michigan, Ann Arbor, USA) and colleagues.

The findings, which appear in JAMA, are based on data from 207,615 adults who took part in the nationally representative US Medical Expenditure Panel Survey.

The 1015 participants who had cerebral palsy had significantly higher rates of all eight studied health conditions. Potentially preventable conditions included obesity, which was present in 41.4% of cerebral palsy patients versus 29.7% of other participants, and hypertension, which was present in 30.0% versus 22.1%, as well as diabetes, stroke, other heart conditions and emphysema. Cerebral palsy patients also had higher rates of asthma, joint pain and arthritis.

After adjustment for confounders including education, income level and race/ethnicity, all comorbidities except for diabetes were significantly more likely to occur in cerebral palsy patients than other participants, with risk increases ranging from 1.32-fold for hypertension to 2.03-fold for emphysema.

Patients with cerebral palsy were older than other participants, at 58 versus 45 years, and Peterson et al note that “[a]ccelerated functional losses are a concern in the aging [cerebral palsy] population.”

They say: “A large percentage of individuals who were once mobile eventually stop ambulating due to fatigue, inefficiency of gait, and/or muscle and joint pain.”

In all, 40.6% and 8.9% of cerebral palsy patients had moderate or severe disability, respectively, compared with 11.3% and 4.9% of other participants. And in the whole study population, all the comorbidities were associated with a significantly increased likelihood of having moderate or severe disability rather than minor or no disability.

Likewise, people with any of the comorbidities were about half as likely as those without them to rate their physical health as good.

“Future efforts are needed to better understand the health care use associated with chronic conditions for persons with [cerebral palsy] and to characterize the relationships among mobility impairments, sedentary lifestyles, and chronic conditions”, say the researchers.

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