Health conditions, functional status and health care utilization in adults with cerebral palsy

Family Practice, 2018, 1–10
doi:10.1093/fampra/cmy027

Robert J Fortuna1,*, Ashley Holub2, Margaret A Turk3, Jon Meccarello4 and Philip W Davidson4

1 Departments of Internal Medicine and Pediatrics and
2 Department of Public Health Sciences, University of Rochester, Rochester, NY, USA,
3 Department of Pediatrics and Physical Medicine and Rehabilitation, State University of New York Upstate Medical University, Syracuse, NY, USA and
4 Department of Pediatrics, Neurodevelopmental and Behavioral Pediatrics, University of Rochester, Rochester, NY, USA

*Correspondence to Robert J. Fortuna, Departments of Internal Medicine and Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA; E-mail: robert_fortuna@urmc.rochester.edu

Abstract

Aim. Health conditions in children with cerebral palsy (CP) are well described, yet health is less defined with advancing age. We examined health conditions, functional status and health care utilization in adults with CP across age groups.

Methods. We collected cross-sectional data on health conditions, functional status and utilization from the medical records of adults with CP across a large university-affiliated primary care network using the Rochester Health Status Survey IV (RHSS-IV), a 58-item validated survey. Data from the National Health and Nutrition Examination Survey and National Health Interview Survey provided prevalence estimates for the general population as comparison.

Results. Compared to the general population, adults with CP had higher rates of seizure disorder, obesity and asthma across all ages. Adults with CP under 30 years of age had higher rates of hypertension (16.7 versus 5.6%; P = 0.04), urinary incontinence (41.7 versus 10.5%; P < 0.001) and depression (16.7 versus 6.9%; P = 0.07). Conversely, there were lower rates of alcohol misuse, tobacco/nicotine and sexually transmitted illnesses. Independence with all activities of daily living decreased from 37.5% at 18–29 years of age to 22.5% in those 60 and over. Seizure disorders, urinary incontinence and gastroesophageal reflux disease were all independently associated with lower functional status. As expected, health care utilization increased with advancing age.

Conclusions: Adults with CP should be monitored for conditions occurring at higher prevalence in CP, as well as common conditions occurring with advancing age. Age-related functional decline should be anticipated, especially with coexisting seizure disorders and urinary incontinence.