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Changes in walking ability, intellectual disability, and epilepsy in adults with cerebral palsy over 50 years: a population‐based follow‐up study
Author(s) -
Jonsson Ulrica,
Eek Meta Nyström,
Sunnerhagen Katharina Stibrant,
Himmelmann Kate
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14871
Subject(s) - cerebral palsy , epilepsy , intellectual disability , population , medicine , pediatrics , physical therapy , body mass index , psychology , physical medicine and rehabilitation , psychiatry , environmental health
Aim To determine if walking ability and presence of intellectual disability and epilepsy change from childhood to 50 years of age in individuals with cerebral palsy (CP), and if such changes are related to age, sex, or CP subtype. Method This was a population‐based follow‐up study of 142 adults born from 1959 to 1978 (82 males, 60 females; mean age 48y 4mo, range 37–58y; 44% unilateral, 35% bilateral, 17% dyskinetic, and 4% ataxic CP) listed in the CP register of western Sweden. We compared childhood data with a follow‐up assessment in 2016. Results At follow‐up, walking ability had changed significantly ( p< 0.001). The proportion of participants walking without aids had decreased from 71% to 62%, and wheelchair ambulation increased from 18% to 25%. Walking ability was related to subtype ( p= 0.001), but not to age, sex, pain, fatigue, or body mass index. The proportion classified as having intellectual disability had increased from 16% to 22% ( p= 0.039) and the proportion with epilepsy from 9% to 18% ( p= 0.015). Of those with childhood epilepsy, 46% were seizure‐free without medication. Interpretation Walking ability and the presence of intellectual disability and epilepsy had changed significantly since childhood. Life‐long access to specialized health care is warranted for re‐evaluation of impairments, treatment, and assistance. What this paper adds Changes in impairments in individuals with cerebral palsy (CP) over time are related to CP subtype. After 50 years, walking ability in CP may have deteriorated or improved. Intellectual disability in CP may not always be detected in early childhood assessments. Epilepsy in CP may develop after childhood or may be outgrown.