Article

A population-based observational study design was used to describe the
epidemiology of intellectual disability in cerebral palsy (CP) in terms of
clinical and neuroimaging associations, and to report the impact of intellectual
disability on utilization of health services and length of survival. METHOD:
Population CP registry data were used to retrospectively assess the frequency of
intellectual disability and strength of associations between intellectual
disability and mobility, epilepsy, vision, hearing, communication, and
neuroimaging patterns (n=1141). Data linkage was undertaken to assess usage of
hospital inpatient and emergency department services. Survival analysis was
performed in a 30-year birth cohort (n=3248). RESULTS: Intellectual disability,
present in 45% of the cohort, was associated with non-ambulation (47% vs 8%),
later walking (mean 2y 7mo vs 1y 9mo), hypotonic (8% vs 1%) or dyskinetic (9% vs
5%) CP, a quadriplegic pattern of motor impairment (42% vs 5%), epilepsy (52% vs
12%), more emergency and multi-day hospital admissions, and reduced 35-year
survival (96% vs 71%). Grey matter injuries (13% vs 6%), malformations (18% vs
6%), and miscellaneous neuroimaging patterns (12% vs 4%) were more common in
people with intellectual disability. INTERPRETATION: Intellectual disability adds
substantially to the overall medical complexity in CP and may increase health and
mortality disparities. WHAT THIS STUDY ADDS: Cerebral maldevelopments and grey
matter injuries are associated with higher intellectual disability rates. Health
care is more 'crisis-driven' and 'reactive' in children with co-occurring
intellectual disability. Length of survival is reduced in individuals with CP and
co-occurring intellectual disability.
CI - (c) 2018 Mac Keith Press.

Langue : ANGLAIS