Aging with Cerebral Palsy

What is aging?


Aging is a conception-to-death progression of developmental
changes that ultimately lessen a person’s ability to cope
successfully with internal needs and with the demands of the
environment. During the early stages of aging (infancy, childhood,
adolescence) skills and capabilities continue to increase; in the
middle stages (i.e., adulthood) maintenance of function is the focus.
Disease, trauma and other challenges can cause a decline in
function at any stage. It is in the later stages of life that function
declines significantly as a result of aging (if disease is not a factor
at any of these stages).

The underlying assumption of this report is that the pattern of aging
as a process is the same in persons with life-long disabilities as it is
in the general population, although the data to substantiate this
assumption are not available.
To understand the aging process, one must focus on all the
changes that occur in the person from the moment of conception
until the moment of death. Aging is not simply a process of
becoming older, less functional, and dying. Growth, development,
acquisition of skills, maintenance of skills and functional
capabilities, repair and replacement, and ultimate decline, are all
parts of aging.

As adults age, they are generally less able to respond to stresses in
the environment as rapidly and effectively as when they were
younger. Numerous diseases can affect a person’s stress response
and may interfere with the body’s ability to generate an appropriate
response. However, it is important to remember these diseases are
not caused by aging but may occur more commonly among
persons who are older. Ultimately, the person becomes biologically
“overwhelmed” by those stresses and dies.

In the past, many researchers and clinicians regarded aging itself
as a “disease,” something to be cured. There is now a more
general acceptance that some of the changes often seen with
increasing age are signs of disease (e.g., dementia, osteoporosis,
and arthritis), rather than signs of the aging process itself. A recent
theory suggests that changes associated with aging are due to
genetically driven processes, and are best described as resulting in
these manifestations: successful, or usual, or pathological.

ß  Successful aging: The successful ager has a positive
genetic inheritance that is unfolding in a positive
environment. Little if any, major functional change occurs in
the person at least until the early to mid-70s. Except for an
occasional acute illness, the person who is aging
successfully has no chronic disease to limit his/her functional
capabilities.

ß  Usual aging: The usual ager has a positive or neutral genetic
program that is unfolding within a neutral or slightly negative
environment (i.e. an environment that puts a person at some
increased risk for dysfunction). The risk of developing disease or
dysfunction is present and will be manifested; it does not however,
seriously or overwhelmingly impair the individual. Function, while
less than that of a person who is aging successfully, is still at a
relatively high level. Disease may be present but does not present
serious functional limitations.

Pathological aging: The pathological ager is at risk of serious
functional limitations for genetic and/or environmental reasons.
Disease is typically serious, may be of long-standing duration, and
may be of multiple types. Function is obviously impaired and may
be poor enough to require continuing home-based or institutional
care. Independence is severely limited.

With increasing age, a shift usually occurs in the type of diseases to
which a person is susceptible. Acute illnesses become less
common (except for viral infections such as “flu”), while chronic
conditions become more common. The likelihood increases for
developing cardiovascular, neurological, respiratory, or kidney
disease, and cancer, in part because of changes taking place in the
immune system.
It is important to remember, however, that while a disease is more
likely to develop in the older person, that disease probably is not
caused by the aging process. Distinguishing between age-related
change and change caused by disease is very difficult in any
population. The distinction between “successful” and “usual” aging
is often not be as sharp and unambiguous as one would like.

Aging, the conception-to-death series of changes, is generally
assumed to follow the same sequence in all people. However, the
rate by which these changes manifest themselves can vary widely.
As in the general population, persons with lifelong conditions such
as cerebral palsy experience growth, development, maintenance of
function, and finally,  loss of function. The three-part descriptors of
aging (successful, usual, and pathological) also apply to them.

Read More
How does aging affect persons with cerebral palsy
Successful aging

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