@article{ref1,
title="Multimorbidity in middle-aged adults with cerebral palsy",
journal="American journal of medicine",
year="2017",
author="Cremer, Nicole and Hurvitz, Edward A. and Peterson, Mark D.",
volume="130",
number="6",
pages="744.e9-744.e15",
abstract="BACKGROUND: 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. <br><br>PURPOSE: To examine the prevalence of lifestyle-related chronic conditions and multimorbidity in a sample of middle-aged adults with cerebral palsy. <br><br>METHODS: A clinic-based sample of middle-aged adults with cerebral palsy was examined using Electronic Medical Records Search Engine (EMERSE) software. Our cohort included n= 435 individuals aged 40-60 years old, with an ICD-9/10-CM Diagnosis Code for cerebral palsy. Prevalence of 12 chronic conditions were 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, pre-hypertension/hypertension, and hyperlipidemia. Multivariate logistic models were used to estimate adjusted mulitmorbidity (i.e., ≥2 chronic conditions), adjusting for age, sex, smoking status, obesity, and Gross Motor Function Classification System (GMFCS). <br><br>RESULTS: There were 137 unique multimorbidity combinations. Multimorbidity was significantly more prevalent among obese versus non-obese 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 non-obese individuals with GMFCS IV-V (64.2%) compared to individuals with non-obese individuals with GMFCS I-III (53.6%). Both obesity status (OR: 2.20; 95% CI 1.32-2.79) and the GMFCS IV-V category (OR: 1.81; 95% CI 1.32-3.68) were independently associated with multimorbidity. <br><br>CONCLUSION: Middle-aged adults with cerebral palsy have high estimates of multimorbidity, and both obesity and higher GMFCS levels are independently associated with greater risk.<br><br>Copyright © 2017. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0002-9343",
doi="10.1016/j.amjmed.2016.11.044",
url="http://dx.doi.org/10.1016/j.amjmed.2016.11.044"
}