Health issues in polyhandicapped patients according to age: Results of a large French survey

Abstract

A better understanding of the natural course of the health status of patients with polyhandicap may optimize preventive and curative care management. From a large sample of patients aged from 3 to 25 years, we reported the description of their health status. This was an 18-month cross-sectional study including patients aged from 3 to 25 years with a combination of severe motor deficiency and profound intellectual impairment. The patients were recruited from 4 specialized rehabilitation centers, 9 residential facilities, and a pediatric/neurological department. The following data were collected: polyhandicap etiology, health status (handicaps, comorbidities, and neurodevelopmental status), medical devices, and rehabilitation procedures. A total of 545 patients were included ( n = 80 [3–5 years], n = 166 [6–11 y], n = 155 [12–17 y], and n = 144 [18–25 y]). The etiology of polyhandicap was unknown for 11% of the cases. Behavioral disorders and (orthopedic and digestive) comorbidities were more frequent in the oldest age classes. The neurodevelopmental status of the patients was close to those of a 5- to 7-month-old child without progression across age. Gastrostomy was the most frequent device needed by the patients. Early detection and management of handicaps and comorbidities may improve the disease course of the patients.