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Transitions in Aging

Aging with Developmental Disabilities

Associated Conditions: Cerebral Palsy

Photo of woman with man in wheelchair

  • Musculoskeletal changes
    • Increasing scoliosis, lower extremity contractures, hip subluxation or dislocation
    • At greater risk for osteoporosis, breathing, and eating difficulties
  • Pain and fatigue
    • Monitor for behavioral changes
    • Treatment planning
  • Change in support needs
    • Seating and positioning
    • Eating and swallowing
    • Communication
    • Skin issues


NEXT: Summary


Notes and References

Day and others (2015) reviewed 17 studies related to life expectancy in individuals with cerebral palsy and reported that, for individuals with mild cerebral palsy, their life expectancy is close to that of the general population.



However, the life expectancy for individuals who have moderate or severe conditions could be 10-15 years shorter than the general population.1 Many studies have reported that adults with cerebral palsy experience accelerated musculoskeletal system aging, and are at a greater risk of developing osteoporosis, chronic fatigue, and chronic pain.2 Musculoskeletal changes (i.e., increased spasticity, and decreased muscle strength and endurance) often lead to decreased function and mobility in this population, and increased risks for falls and fractures.2 Other common musculoskeletal complaints are increasing scoliosis, lower extremity contractures, and hip subluxation or dislocation. To maintain their level of independence, researchers have suggested that this population consider early surgical interventions, regular exercise, and use well-fitted assistive devices.3

Chronic fatigue and pain are the most prevalent complaints in individuals with cerebral palsy. It was found that the prevalence of chronic pain and pain frequency in this population increase as one ages.5 Adults with cerebral palsy most frequently report pain in the back and weight-bearing joints. Stretching and flexibility exercises might help ease joint contractures and assist in pain management.6 As pain and fatigue can affect one's quality of life and willingness in activity participation, it is important to monitor one's level of pain and fatigue. Some easily observable signs are an individual becoming socially isolated or showing other behavioral changes (i.e., quiet, disinterest). In addition, ill-fitting equipment can increase one's work-related fatigue, pain, and discomfort.7 Therefore, the use of a well-fitted assistive device, including specialized seating and a mobility system, is vital for this population.

Finally, the wheelchair-seated posture generates pressures in the bottom of the spine and hips, placing individuals with cerebral palsy at high risk for pressure sores.8 To avoid development of pressure sores, it is recommended to use a proper cushion to adjust seating, to shift weight every 15 to 20 minutes, and to use a properly fitted wheelchair. It is also important to continually monitor for changing needs in one's eating, communication, and skin conditions.

References:

  1. Day, S. M., Reynolds, R. J., & Kush, S. J. (2015). Extrapolating published survival curves to obtain evidence-based estimates of life expectancy in cerebral palsy. Developmental Medicine & Child Neurology, 57(12), 1105-1118.
  2. Haak, P., Lenski, M., Hidecker, M. J. C., Li, M. I. N., & Paneth, N. (2009). Cerebral palsy and aging. Developmental Medicine & Child Neurology, 51, 16-23.
  3. Turk, M. A., Overeynder, J. C., & Janicki, M. P. (1995). Uncertain Future: Aging and Cerebral Palsy, Clinical Concerns. Albany: New York State Developmental Disabilities Planning Council.
  4. Jahnsen, R., Villien, L., Stanghelle, J. K., & Holm, I. (2003). Fatigue in adults with cerebral palsy in Norway compared with the general population. Developmental Medicine & Child Neurology, 45, 296-303.
  5. Jahnsen, R., Villien, L., Aamodt, G., Stanghelle, J. K., & Holm, I. (2004). Musculoskeletal pain in adults with cerebral palsy compared with the general population. Journal of Rehabilitation Medicine, 36, 78-84.
  6. Andersson, C., & Mattsson, E. (2001). Adults with cerebral palsy: A survey describing problems, needs, and resources with special emphasis on locomotion. Developmental Medicine & Child Neurology, 43, 76-82.
  7. Hammel, J., Lai, J., & Heller, T. (2002). The impact of assistive technology and environmental interventions on function and living situation status with people who are ageing with developmental disabilities. Disability and Rehabilitation, 24(1/2/3), 93-105.
  8. Klingbeil, H., Baer, H. R., & Wilson, P. E. (2004). Aging with a disability Archives of Physical Medicine and Rehabilitation, 85, Supplement 3, 68-73.