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Characteristics and Health Issues of Adults With Cerebral Palsy in Ontario

Applied Health Research Question submitted to H-CARDD by the Toronto Rehabilitation Institute

Authors: Caitlin McGarry, Robert Balogh, Carly McMorris, Johanna Lake, Kristin Dobranowski, Andrew Wilton, & Yona Lunsky

Background

Cerebral palsy is a chronic, non-progressive physical disability characterized by motor impairments caused by central nervous system injury early in development. Preliminary evidence suggests high rates of comorbid physical and mental health problems in this population.

Purpose

The purpose of this report was to describe the characteristics and occurrence of comorbid physical and mental health problems of adults with cerebral palsy.

Methods

The records of 14,155 Ontario adults with cerebral palsy aged 18 to 64 years were identified from health administrative databases held at the Institute for Clinical Evaluative Sciences. Of these, 4,767 (33.7%) had a developmental disability. Two comparison groups were created: adults with developmental disabilities excluding persons with cerebral palsy and a 20% random sample of the adult population in Ontario without cerebral palsy and without developmental disabilities. Comparisons were also made among adults with cerebral palsy, comparing those with and without developmental disabilities.

Results

  • Compared to the general population and compared to adults with developmental disabilities, adults with cerebral palsy were more likely to be young and to be male.
  • They were more likely than the general population to reside in neighbourhoods in the lowest income quintile; however, income quintiles were more evenly distributed among adults with cerebral palsy than among adults with developmental disabilities only.
  • Consistent with findings among adults with developmental disabilities only, individuals with cerebral palsy were more likely to have mental health problems than the general population; individuals with cerebral palsy and developmental disabilities were also more likely to have comorbid mental health problems than those with cerebral palsy only.
  • Similar to adults with developmental disabilities only, a greater proportion of individuals with cerebral palsy had chronic diseases compared to the general population. Individuals with cerebral palsy only were more likely to have asthma and hypertension than any other group studied.
  • Like adults with developmental disabilities only, adults with cerebral palsy had higher levels of morbidity than the general population; however, individuals with cerebral palsy and developmental disabilities had higher morbidity levels than those with cerebral palsy only.

Conclusions and Implications

Consistently, individuals with cerebral palsy showed a pattern of health services need that was higher than the general population. This pattern is similar to what is observed in individuals with developmental disabilities. These findings can be used to inform future staff training, policy development, and resource utilization among adults with cerebral palsy.