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Multimorbidity in Middle-Aged Adults with Cerebral Palsy - 27/09/17

Doi : 10.1016/j.amjmed.2016.11.044 
Nicole Cremer, BS a, Edward A. Hurvitz, MD b, Mark D. Peterson, PhD, MS b,
a University of Michigan, University of Michigan Medical School, Ann Arbor 
b Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor 

Requests for reprints should be addressed to Mark D. Peterson, PhD, MS, Department of Physical Medicine and Rehabilitation, University of Michigan Hospital and Health Systems, 325 E. Eisenhower Parkway, Suite 300, Ann Arbor, MI 48108.Department of Physical Medicine and RehabilitationUniversity of Michigan Hospital and Health Systems325 E. Eisenhower Parkway, Suite 300Ann ArborMI48108

Abstract

Objective

Individuals with cerebral palsy have less lean body mass, greater relative adiposity, and lower fitness and physical activity participation, and yet the prevalence of age-related multimorbidity in this population has yet to be established. The study objective was to examine the prevalence of lifestyle-related chronic conditions and multimorbidity in a sample of middle-aged adults with cerebral palsy.

Methods

A clinic-based sample of middle-aged adults with cerebral palsy was examined using Electronic Medical Records Search Engine software. Our cohort included 435 individuals aged 40 to 60 years, with an International Classification of Diseases, Clinical Modification, 9th and 10th Revisions Diagnosis Code for cerebral palsy. Prevalence of 12 chronic conditions was evaluated, including existing diagnoses or historical record of osteopenia/osteoporosis, myocardial infarction, stroke, coronary artery disease, impaired glucose tolerance/type 2 diabetes, other cardiovascular conditions, rheumatoid arthritis, osteoarthritis, asthma, emphysema, prehypertension/hypertension, and hyperlipidemia. Multivariate logistic models were used to estimate multimorbidity (ie, ≥2 chronic conditions), adjusting for age, sex, smoking status, obesity, and Gross Motor Function Classification System (GMFCS).

Results

There were 137 unique multimorbidity combinations. Multimorbidity was significantly more prevalent among obese versus nonobese individuals for both GMFCS I-III (75.8% vs 53.6%) and GMFCS IV-V (79.0% vs 64.2%), but was also significantly higher in nonobese individuals with GMFCS IV-V (64.2%) compared with nonobese individuals with GMFCS I-III (53.6%). Both the obesity status (odds ratio, 2.20; 95% confidence interval, 1.32-2.79) and the GMFCS IV-V category (odds ratio, 1.81; 95% confidence interval, 1.32-3.68) were independently associated with multimorbidity.

Conclusions

Middle-aged adults with cerebral palsy have high estimates of multimorbidity; both obesity and higher GMFCS levels are independently associated with greater risk.

Le texte complet de cet article est disponible en PDF.

Keywords : Cerebral palsy, Diabetes, Hypertension, Multimorbidity, Obesity, Osteoporosis


Plan


 Funding: NC is funded by the University of Michigan Medical School Summer Biomedical Research Program. MDP is funded by the National Institutes of Health (1KO1 HD074706) and the National Institute on Disability, Independent Living, and Rehabilitation Research (90IF0102-01). The funders had no role in the design and conduct of the study; the collection, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.
 Conflict of Interest: None.
 Authorship: All authors had access to the data and played a role in writing this manuscript.


© 2017  Elsevier Inc. Tous droits réservés.
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Vol 130 - N° 6

P. 744.e9-744.e15 - juin 2017 Retour au numéro
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