title: Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy.
abstract: BACKGROUND
  Studies have noted high rates of specific health disorders in adults with cerebral palsy (CP). However, it remains unclear how growing older with a lifelong neuromotor physical disability confers risk for health outcomes in adults who have both intellectual disability (ID) and CP.
  
  
  OBJECTIVE
  To assess the relationship between health status in older adults with ID either with or without coincident diagnoses of CP.
  
  
  METHODS
  Health status data were drawn from 1373 adults aged 33 to 79 years with ID living in small group homes in New York State. Their health status was defined by the presence of common health disorders. Of these, 177 subjects had coincident CP. Prevalence data for nine diseases representing different organ systems were obtained and compared in individuals with and without CP. A Severity of Functional Impairment Index (SFII) was developed based on subjects' capabilities in activities of daily living (ADLs) and mobility. Two logistic regression analyses were conducted to determine if CP diagnosis was an independent predictor of health disorder prevalence, or rather exerted effects similar to those without CP via severity of functional impairment as determined by SFII scores. In addition, older age, gender, and severity of intellectual disability were examined as predictors of health disorder prevalence in all study subjects.
  
  
  RESULTS
  Individuals with CP had higher frequencies in four out of the nine health disorders (overweight/obesity, gastroesophageal reflux, urinary tract infections and dysphagia). Analysis revealed a statistically significant association between SFII score and CP diagnosis. CP diagnosis alone was a statistically significant predictor for all of the above four common disorders; however, after adjustment for SFII score was included in health disorder models, only dysphagia showed an independent correlation with a CP diagnosis.
  
  
  CONCLUSIONS
  With the exception of dysphagia, impairment in ADLs and walking capabilities, and not CP diagnosis alone, accounted for disparities in specific diseases. Although the diagnosis of CP may be correlated with functional impairment, it alone may play a minor role in determining health trajectories in older persons with conjoint ID and CP.
authors.affiliation: University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, USA. chender3@rochester.rr.com
authors.forename: C M
authors.initials: CM
authors.lastname: Henderson
authors.forename: M
authors.initials: M
authors.lastname: Rosasco
authors.forename: L M
authors.initials: LM
authors.lastname: Robinson
authors.forename: J
authors.initials: J
authors.lastname: Meccarello
authors.forename: M P
authors.initials: MP
authors.lastname: Janicki
authors.forename: M A
authors.initials: MA
authors.lastname: Turk
authors.forename: P W
authors.initials: PW
authors.lastname: Davidson
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D000368:Aged; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003680:Deglutition Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009518:New York; D012307:Risk Factors