Doctors alone are not experts on the life expectancy for adults with cerebral
palsy. Only a physician is qualified to appraise the individual, and only a
statistician or actuary is qualified to relate the appraisal into a life
expectancy for adults with cerebral palsy. Life expectancy for adults with
cerebral palsy has many factors such as the type, severity and associated
disabilities as well as the quality of care. The life expectancy for adults with
cerebral palsy can range from about 30 years for those with rigidity or severe
spasticity associated and feeding difficulties, to 60 to 70 years for those with
moderate cerebral palsy. The life expectancy for adults with cerebral palsy for
those with mild disability and no associated impairments is normal compared to
that of the non-disabled.
Findings from a recent study suggest that most persons with cerebral palsy
will eventually suffer a decline in gross motor function, such as the ability to
walk. In some instances, these musculoskeletal problems common in those with
spasticity require repeated orthopedic surgeries. Keeping a patient ambulatory
(able to walk) greatly increases their survival rate into the later years of
life. While those retaining at least some ability to walk can expect a survival
rate similar to that in the general population, this rate is much worse for
those suffering from low functional ability. The key role of mobility as a
predictor of survival in the elderly is consistent with research on younger
persons with cerebral palsy.
The loss of the ability to walk should be considered part of the natural
history of a person suffering from cerebral palsy. It is evident that
therapeutic emphasis should perhaps be redirected in childhood from maximizing
motor skills to more of a long-term view. Instead a more independence-oriented
therapeutic approach would be appropriate in determining a mindset of long-term
life. Approaches must be designed to promote muscle strengthening, avoid
surgical procedures that produce muscle weakening, and promote social and
independence skills and educational achievements to further the life expectancy
for adults with cerebral palsy.
Foremost, consideration needs to be given to mobility whenever possible. It
is important to avoid the development of muscle contractures and joint changes
by the proper use of physiotherapy, hydrotherapy and medical and surgical
treatments for spasticity.
Secondly, even when mobility is lost, meticulous attention to maintaining
good, seated posture by the use of appropriate wheelchairs and static seating is
necessary. This needs to be combined with measures to treat and reduce pain,
stemming from stiffened joints. This will help to reduce the development of
postural spinal scoliosis.
The third principal is maintaining good nutritional status through a
high-fiber and low-fat diet. This will help to maintain continence and alleviate
constipation.
It is not helpful to make generalizations on the life expectancy for adults
with cerebral palsy. What matters is that they receive the appropriate health
care and enjoy a satisfying range of occupational interests and social
activities. The wish and will to live under these circumstances is particularly
important in extending the life expectancy in adults with cerebral palsy.
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