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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.