How CP Changes With Age
Cerebral palsy is not a progressive condition — the brain injury doesn't get worse. However, the effects of CP on the body can change significantly over time. Many adults with CP report functional decline earlier than the general population.
Common changes include:
- Increasing muscle tightness and joint contractures
- Progressive joint degeneration (arthritis) from abnormal movement patterns over decades
- Increased fatigue — often beginning in the 20s and 30s
- Decreased walking ability — some people who walked as children may transition to using a wheelchair
- Increased pain — particularly musculoskeletal pain
- Changes in swallowing and eating
Early Ageing Effects
Research suggests that adults with CP experience age-related changes 20–30 years earlier than the general population. This “premature ageing” is thought to be related to:
- The extra physical demands of living with CP for decades
- Wear and tear on joints from abnormal biomechanics
- Cumulative effects of spasticity on the musculoskeletal system
- Reduced physical activity and deconditioning over time
- Less access to age-appropriate healthcare
Maintaining Health & Function
Proactive strategies can help maintain function and quality of life:
- Regular exercise — adapted fitness programs, swimming, yoga, cycling (adapted bikes)
- Ongoing physiotherapy — maintenance therapy to prevent decline, not just childhood intervention
- Weight management — reduced mobility makes weight gain more likely, which increases strain on joints
- Bone health — many people with CP have osteoporosis. Calcium, vitamin D, and weight-bearing activities help
- Regular health screening — standard age-appropriate screening (cancer, heart, diabetes) plus CP-specific monitoring
- Mental health support — addressing the emotional challenges of functional change
- Equipment reviews — regular reassessment of wheelchair, orthotics, and other equipment as needs change
Transition to Adult Services
The transition from paediatric to adult health services is a critical period. In Australia, this typically happens between ages 16 and 25. Challenges include:
- Loss of established clinical relationships
- Adult services that may be less familiar with CP
- Fewer multidisciplinary CP clinics for adults than for children
- Need to navigate the NDIS and other systems independently
Planning for transition should start early — ideally from age 14–16 — and involve the young person, their family, and both paediatric and adult service providers.
Future Planning
Long-term planning is important for everyone, but especially so for people with CP:
- Housing — considering accessible living options for the long term
- Support needs — anticipating that support needs may increase with age
- Financial planning — special disability trusts, superannuation, insurance
- Guardianship and legal planning — powers of attorney, advance care directives
- NDIS planning — ensuring plans reflect changing needs over time
Ageing with CP requires planning, proactive healthcare, and the understanding that needs will change. With the right support, adults with CP can continue to live fulfilling, active lives.