Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy


  • This research was supported by the Strong Children's Research Center and Grant No. H133B031134 to the University of Illinois at Chicago from the US Department of Education, Office of Special Education and Rehabilitative Services, National Institute on Disability and Rehabilitation Research and Grant No. 90DD0590 to the University of Rochester from the US Department of Health and Human Services, Administration on Children and Families, Administration on Developmental Disabilities.

Dr C. Michael Henderson, Strong Center for Developmental Disabilities, PO Box 671, University of Rochester, School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA (e-mail:


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.

Aim  To assess the relationship between health status in older adults with ID either with or without coincident diagnoses of CP.

Method  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.

Conclusion  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.