title: Outcome and life satisfaction of adults with myelomeningocele.
abstract: BACKGROUND
  Myelomeningocele (MMC) commonly causes impairments in body structure and functions as well as cognitive disabilities that can have an adverse effect on adult life. Improved medical care has resulted in increased numbers of individuals with MMC surviving to adulthood, however little is known about the impact of MMC on the lives of adults age 25 years or older.
  
  
  OBJECTIVE
  To gain a better understanding of outcomes in education, employment, relationships, reproduction and life satisfaction of adults with MMC.
  
  
  METHODS
  A primarily quantitative multiple-choice questionnaire designed to capture outcomes in education, employment, relationships and reproduction, along with a previously validated life satisfaction checklist (LiSat-11), was completed by adults with MMC. Relationships between demographic variables, outcomes and life satisfaction were determined using cross tabulation analysis, logistic regression and linear regression.
  
  
  RESULTS
  Ninety adults with MMC, age 25-85 years (median age 32), reported a diverse range of outcomes in education, employment, relationships and reproduction. The most consistent variable associated with difficulty attaining adult milestones was hydrocephalus, the presence of which reduced the likelihood of living independently (p ≤ 0.001), having a partner (p = 0.003) and reproducing (p ≤ 0.001), but did not contribute to reduced life satisfaction.
  
  
  CONCLUSIONS
  Adults with MMC, especially those without hydrocephalus, can obtain gainful employment, live independently, form partner relationships and have children, and these achievements contribute to life satisfaction. While MMC does not affect overall reported life satisfaction for adults, attention should be paid to specific domains with less reported satisfaction.
authors.affiliation: Center for Human Genetics, Duke University Medical Center, 905 S. LaSalle St., Box 3445, Durham, NC 27710, USA. heidi.cope@duke.edu
authors.forename: Heidi
authors.initials: H
authors.lastname: Cope
authors.forename: Kelly
authors.initials: K
authors.lastname: McMahon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Heise
authors.forename: Sonja
authors.initials: S
authors.lastname: Eubanks
authors.forename: Melanie
authors.initials: M
authors.lastname: Garrett
authors.forename: Simon
authors.initials: S
authors.lastname: Gregory
authors.forename: Allison
authors.initials: A
authors.lastname: Ashley-Koch
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D006849:Hydrocephalus; D057187:Independent Living; D007398:Interpersonal Relations; D008297:Male; D008591:Meningomyelocele; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life; D012098:Reproduction; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires