Learning About Cerebral Palsy in Older Adults

Cerebral palsy (CP) is the name for a group of nerve problems that make it hard for a person to control movement. It's caused by injury to the brain. In most cases, this injury happens before birth.

CP is a lifelong condition that needs to be managed. The brain injury that caused CP does not get worse over time. But problems from CP can appear, change, or increase as you age.

How you are affected as you age depends on the type of CP you have. It also depends on how severe it is. Some adults with CP can live on their own. Others may need lifelong care from family members or other caregivers.

The symptoms of CP may change or get worse as you get older. Symptoms can range from mild to severe. And they may be different for each person.

A person may have:

• Problems with body movement and posture.
• Weak muscles in their face, tongue, arms, legs, hands, or feet.
• A limp or a hard time walking.
• Little or no control over their arms and legs or other parts of their body, such as the mouth and tongue. This may cause problems with eating and speaking.

CP can put extra stress and strain on your body. You may need to watch for some problems as you age. These can include:

• Worsening issues with your muscles, bones, joints, tendons, and ligaments.
• Early muscle loss.
• More trouble moving around and doing daily activities.
• Problems with sensations. Some people with CP feel pain even when lightly touched. Even everyday activities may hurt, like brushing teeth. This can lead to dental problems.
• Skin problems caused by moisture. Weakness in the face and throat muscles can cause drooling, which can bother the skin around the mouth, chin, and chest.
• Tiredness (fatigue) and pain that get worse over time. This may include hip pain, muscle pain, and joint pain.
• A higher risk of falls and of being injured from falls and other accidents.

People with CP may be more likely to develop other health problems as they get older. They might have bladder and bowel issues, like constipation. They may have a harder time eating and swallowing. This can cause choking, changes in their appetite, and problems getting the nutrients they need to stay healthy.

People with CP may also have problems with their vision or hearing. And they may have trouble sleeping. Some people with CP have spinal curves (scoliosis). If this curve is severe, it can cause pain and make it hard to breathe.

Osteoarthritis can also happen with CP. It’s the type of arthritis that many people get as they age. It can be painful. People with CP may also have bones that have become thin and weak. This is called osteoporosis. It can lead to broken bones.

Seizures or an intellectual disability can also happen with CP. But these are more likely in people who have severe forms of CP.

People with CP may also be at a higher risk for certain health conditions, such as:

• Mental health conditions, like anxiety and depression.
• Dementia and Alzheimer’s disease.
• Lung disease (such as COPD, pneumonia, asthma, and emphysema).
• Stroke.
• Diabetes.
• High blood pressure.
• Kidney disease.
• Some types of cancer.

Treatment for CP depends on your symptoms, your goals, and any other health conditions you have. Work with your doctor to find the treatment options that are best for you.

Treatment may include:

• Physical therapy.
• Regular doctor visits to check for changes in your health.
• Referrals to medical specialists. These could include an orthopedic surgeon, a urologist, a gastroenterologist, and a physical medicine and rehabilitation doctor (physiatrist).
• Pain management. This can help with short- and long-term pain.
• Medicines. These can help with symptoms of CP and problems caused by CP. They can also treat other health conditions related to CP.
• Assistive devices. These are tools that help make your daily activities easier. You may also hear them called adaptive equipment. For example, some people with CP use walkers or wheelchairs. Electronic assistive technology may also be useful, like speech boards, hearing aids, and tablets.
• Treatment for other health conditions, like pneumonia.
• Referrals for other types of treatment. This may include occupational therapy, speech and language therapy, and massage therapy. You may also benefit from mental health services, learning disability services, and nutritional counseling from a registered dietitian.
• Surgery. For example, you may have orthopedic surgery to treat tight muscles.
• Screening tests to look for a certain disease or condition. These might include osteoporosis, arthritis, mental health conditions, problems with eating, and pain.

Here are some ways to care for yourself when you have CP as an older adult.

• Be sure to go to regular doctor visits. If you can, find a doctor who knows a lot about CP. Get the tests your doctor recommends.
• Be safe with medicines. Take your medicines exactly as prescribed. Contact your doctor if you think you are having a problem with your medicine.
• Ask your doctor about treatments that can help with symptoms of CP, like physical therapy. Physical therapy can help keep you moving the best you can.
• Work with your doctor to build a care team.
• Talk to your doctor about managing pain, if needed. You and your doctor can work together to find ways to manage pain.
• Get regular movement. Your doctor can help you create an activity plan that’s right for you. Be sure to talk to your doctor before starting a new exercise program. You could:
  • Go to a gym. Look for a gym that has fitness professionals and equipment for people with disabilities.
  • Exercise at home. Try using online programs and videos, like the ones from the National Center on Health, Physical Activity and Disability.
• Brush your teeth 2 times a day, and floss once a day. Ask your dentist about special toothbrushes, if needed. Get regular dental checkups. You may want to find a dentist who works with people with CP.
• Eat healthy foods. Choose fruits, vegetables, whole grains, lean protein, and dairy. If you have trouble eating, drinking, or swallowing, tell your doctor. Your doctor can refer you to a speech therapist or a dietitian.
• Make your home as safe as possible to prevent falls. Store items within easy reach. Keep walking paths clear by removing throw rugs. Have someone install handrails on stairways and grab bars on your shower or tub. Ask your doctor for more tips.
• Talk to your doctor about changing or adding assistive devices. These may include special crutches, orthotics, special seats, walkers, and wheelchairs.
• Ask your doctor about help with transportation, if needed. Many communities have programs that give rides to doctor visits and other appointments. Also ask about accessible screening tests, such as for breast cancer.
• Take care of your mental health. Being active and spending time with family and friends can help.
• If you feel depressed or anxious, talk to someone. A counselor can help. If you don’t have a counselor, talk to your doctor. They can help you find a counselor or a support group for people with CP.
• Try to get enough sleep. If you have trouble sleeping, tell your doctor. They can give you tips to help you sleep better. They may also recommend a sleep study.
• Practice safer sex.Getting tested, using condoms or dental dams, and limiting sex partners can help prevent STIs.
• Talk with your employer if you need certain accommodations at work. Your employer can help put support in place, like providing extra breaks, an accessible desk or chair, or access to a different bathroom.