Age-related Trends in Cardiometabolic Disease Among Adults with Cerebral Palsy

Overview

Journal Dev Med Child Neurol

Date 2018 Apr 29

PMID 29704244

Citations 19

Authors

Mark D Peterson

Neil Kamdar

Edward A Hurvitz

Affiliations

Soon will be listed here.

Abstract

Aim: To examine the longitudinal trends of cardiometabolic diseases in a large sample of adults with cerebral palsy (CP).

Method: The Optum Clinformatics Data Mart is a de-identified nationwide claims database of beneficiaries from a single private payer. Beneficiaries were included if they had an International Classification of Diseases, Ninth Revision, Clinical Modification code for a diagnosis of CP. Adults with at least 3 years of continuous enrollment on a single plan between 2002 and 2009 were included in the final analyses (n=2659). We examined the longitudinal trends of incident diabetes mellitus, hypercholesterolemia, hypertension, cardiac dysrhythmias, and atherosclerosis, stratified by age categories: 18 to 39 years, 40 to 59 years, and 60 years and over. Kaplan-Meier product-limit survival curves were compared across age categories for each of the cardiometabolic outcomes, and a Cox proportional hazards regression was run to determine adjusted hazard ratios.

Results: The cumulative incidence of each of the cardiometabolic diseases ranged from 6.0% for atherosclerosis to 34.4% for hypercholesterolemia at 3 years and over. Risk-adjusted Cox proportional hazard models revealed that age was a robust predictor of survival for each outcome, with higher hazard ratio ranges in middle age (hazard ratio 1.41-2.72) and older adults (hazard ratio 2.20-5.93) compared with young adults.

Interpretation: Adults with CP have high rates of cardiometabolic diseases; and disease-free survival shortens significantly with higher ages.

What This Paper Adds: Adults with cerebral palsy have high rates of cardiometabolic diseases. Disease-free survival of all cardiometabolic diseases shortens significantly with higher ages. The highest rates were for hypercholesterolemia and hypertension.

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References

Peterson M, Zhang P, Haapala H, Wang S, Hurvitz E . Greater Adipose Tissue Distribution and Diminished Spinal Musculoskeletal Density in Adults With Cerebral Palsy. Arch Phys Med Rehabil. 2015; 96(10):1828-33. PMC: 4601929. DOI: 10.1016/j.apmr.2015.06.007. View

Ryan J, Allen E, Gormley J, Hurvitz E, Peterson M . The risk, burden, and management of non-communicable diseases in cerebral palsy: a scoping review. Dev Med Child Neurol. 2018; 60(8):753-764. DOI: 10.1111/dmcn.13737. View

Whitney D, Singh H, Miller F, Barbe M, Slade J, Pohlig R . Cortical bone deficit and fat infiltration of bone marrow and skeletal muscle in ambulatory children with mild spastic cerebral palsy. Bone. 2016; 94:90-97. PMC: 5912954. DOI: 10.1016/j.bone.2016.10.005. View

Borza T, Jacobs B, Montgomery J, Weizer A, Morgan T, Hafez K . No Differences in Population-based Readmissions After Open and Robotic-assisted Radical Cystectomy: Implications for Post-discharge Care. Urology. 2017; 104:77-83. PMC: 5449208. DOI: 10.1016/j.urology.2017.01.042. View

Nicolaides A, Panayiotou A . Screening for Atherosclerotic Cardiovascular Risk Using Ultrasound. J Am Coll Cardiol. 2016; 67(11):1275-7. DOI: 10.1016/j.jacc.2016.01.016. View

Strauss D, Cable W, Shavelle R . Causes of excess mortality in cerebral palsy. Dev Med Child Neurol. 1999; 41(9):580-5. DOI: 10.1017/s001216229900122x. View

Maenner M, Blumberg S, Kogan M, Christensen D, Yeargin-Allsopp M, Schieve L . Prevalence of cerebral palsy and intellectual disability among children identified in two U.S. National Surveys, 2011-2013. Ann Epidemiol. 2016; 26(3):222-6. PMC: 5144825. DOI: 10.1016/j.annepidem.2016.01.001. View

Espeland M, Crimmins E, Grossardt B, Crandall J, Gelfond J, Harris T . Clinical Trials Targeting Aging and Age-Related Multimorbidity. J Gerontol A Biol Sci Med Sci. 2017; 72(3):355-361. PMC: 5777384. DOI: 10.1093/gerona/glw220. View

Whitney D, Hurvitz E, Ryan J, Devlin M, Caird M, French Z . Noncommunicable disease and multimorbidity in young adults with cerebral palsy. Clin Epidemiol. 2018; 10:511-519. PMC: 5935087. DOI: 10.2147/CLEP.S159405. View

10.

Meade M, Mahmoudi E, Lee S . The intersection of disability and healthcare disparities: a conceptual framework. Disabil Rehabil. 2014; 37(7):632-41. DOI: 10.3109/09638288.2014.938176. View

11.

Cremer N, Hurvitz E, Peterson M . Multimorbidity in Middle-Aged Adults with Cerebral Palsy. Am J Med. 2017; 130(6):744.e9-744.e15. PMC: 5502778. DOI: 10.1016/j.amjmed.2016.11.044. View

12.

Palisano R, Di Rezze B, Stewart D, Rosenbaum P, Hlyva O, Freeman M . Life course health development of individuals with neurodevelopmental conditions. Dev Med Child Neurol. 2017; 59(5):470-476. DOI: 10.1111/dmcn.13402. View

13.

Wilkinson D, Johnson K, Garton H, Muraszko K, Maher C . Trends in surgical treatment of Chiari malformation Type I in the United States. J Neurosurg Pediatr. 2016; 19(2):208-216. DOI: 10.3171/2016.8.PEDS16273. View

14.

Oskoui M . Growing up with cerebral palsy: contemporary challenges of healthcare transition. Can J Neurol Sci. 2012; 39(1):23-5. DOI: 10.1017/s0317167100012634. View

15.

Peterson M, Ryan J, Hurvitz E, Mahmoudi E . Chronic Conditions in Adults With Cerebral Palsy. JAMA. 2015; 314(21):2303-5. PMC: 4862577. DOI: 10.1001/jama.2015.11025. View

16.

Rose J, McGill K . Neuromuscular activation and motor-unit firing characteristics in cerebral palsy. Dev Med Child Neurol. 2005; 47(5):329-36. DOI: 10.1017/s0012162205000629. View

17.

Peterson M, Gordon P, Hurvitz E, Burant C . Secondary muscle pathology and metabolic dysregulation in adults with cerebral palsy. Am J Physiol Endocrinol Metab. 2012; 303(9):E1085-93. PMC: 3492860. DOI: 10.1152/ajpendo.00338.2012. View

18.

Ryan J, Crowley V, Hensey O, McGahey A, Gormley J . Waist circumference provides an indication of numerous cardiometabolic risk factors in adults with cerebral palsy. Arch Phys Med Rehabil. 2014; 95(8):1540-6. DOI: 10.1016/j.apmr.2014.03.029. View

19.

Moreau N, Li L, Geaghan J, Damiano D . Fatigue resistance during a voluntary performance task is associated with lower levels of mobility in cerebral palsy. Arch Phys Med Rehabil. 2008; 89(10):2011-6. PMC: 2668210. DOI: 10.1016/j.apmr.2008.03.012. View

20.

Stem M, Blachley T, Shtein R, Herman W, Gardner T, Stein J . Impact of diagnosing diabetic complications on future hemoglobin A1c levels. J Diabetes Complications. 2016; 30(2):323-8. PMC: 7531043. DOI: 10.1016/j.jdiacomp.2015.11.007. View