Adults with cerebral palsy twice as likely to develop cardiovascular, chronic respiratory diseases

Adults with cerebral palsy are about twice as likely to develop cardiovascular disease and chronic respiratory disease compared to adults without cerebral palsy, according to a new study led by RCSI (Royal College of Surgeons in Ireland) and Brunel University London.

The study compared 1,700 adults with cerebral palsy and 5,000 adults without cerebral palsy to identify how many developed non-infectious diseases, such as asthma or stroke. The research is published in the current edition of Neurology.

Patients with cerebral palsy were overall 75% more likely to have a non-communicable disease. After adjusting for other variables, the study found that adults with cerebral palsy were around twice as likely to develop cardiovascular disease and chronic respiratory disease, such as asthma, but not more likely to develop diabetes or cancer.

Adults with cerebral palsy were specifically 2.6 times more likely to develop heart failure, 5.5 times more likely to have a stroke, 2.2 times more likely to develop asthma, 1.6 times more likely to develop hypertension and 2.3 times more likely to develop ischaemic heart disease.

Globally, approximately 17 million people have cerebral palsy. Although cerebral palsy was historically considered a pediatric condition, the majority of children with cerebral palsy now survive into adulthood and many adults with cerebral palsy have a near normal life expectancy.

Cerebral palsy is not a progressive condition. However, at least a quarter of young adults report that their ability to walk gets worse, which may contribute to the development of chronic health conditions.

Until recently, we did not know much about the consequences of aging with cerebral palsy. Our findings highlight the need for further research into the management of non-communicable diseases in this population.

Recent clinical guidelines for adults with cerebral palsy in the UK recommended that pathways need to be developed that allow adults with cerebral palsy access to a multidisciplinary team. However, adults with cerebral palsy in Ireland lack access to co-ordinated multidisciplinary support."

Jennifer Ryan, study's lead author and StAR Research Lecturer at RCSI and Senior Lecturer at Brunel University London

Being able to access health professionals, such as physiotherapists, orthopedic surgeons and neurologists with knowledge of cerebral palsy early, may slow deterioration in the patient's function and prevent development of secondary conditions with age.

Dr Neil O'Connell, co-author, physiotherapist and senior lecturer at Brunel University London said:

Our results clearly emphasize the importance of reframing how cerebral palsy is traditionally viewed; to recognize that it is not simply a condition of childhood. Health services should be designed and delivered with the aim of supporting people with cerebral palsy to be healthy and active throughout their lives."

Source:
Journal reference:

Ryan, J.M. et al. (2019) Noncommunicable disease among adults with cerebral palsy. A matched cohort study. Neurology. doi.org/10.1212/WNL.0000000000008199.

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