There is a paucity of reliable information about both the aging process in persons with disabilities and about the effects of aging on a specific disability. One of several problems is what do we mean by "aging": the wear and tear of use over time on a body part? The biological process of aging in which there is believed to be active "degeneration" of a body part or parts? A biological process in which there is a failure of the continuing repair needed to maintain the body part? An increasing failure to be able to "adapt" physically and/or mentally to change by using other systems?

However, there are several generalities about aging that are accepted as "conventional wisdom":

• The function and often structures of most body parts decline over time, particularly after growth and development has stopped and maturity has been reached.
• If the body part already has a deficit, it is at greater risk of additional structural and/or functional loss over time.
• The performance capabilities of a person may increase more slowly or may diminish after maturity.
• Since developmental disabilities occur very early in life, they influence lifestyles during the entire life span. Lifestyles have a major impact both on the occurrence of new disabilities and on the progression of already existing disabilities.

Overall, as a result of the above: (1) persons with disabilities such as those associated with cerebral palsy, often develop additional disabilities (e.g., : arthritis, pain) at an earlier age than does the general population; and (2) the limitation of function associated with a specific disability can increase over time (note: it can also decrease over time).

As indicated above, there is still too little research providing information specifically addressing aging in persons with developmental disabilities. However, there is a growing body of information on aging, health risks and cumulative disability in the general population. What can we learn from that?

In a special article recently published in a medical journal¹ and an editorial comment in the same journal, a study was presented which explored the question whether lifetime disability is greater in persons with lower health risks than in persons with higher health risks. To put it another way: do prevention measures postpone the onset of chronic illness and disability? Some contend that healthier lifestyles may actually increase illness late in life by increasing the number of years a person can survive with a chronic illness. Thus, the longer you live, the longer you may live with a disability.

The question that was studied was: do persons with improved lifestyles develop a disability later in life, and do they have fewer total disabilities than persons with poorer lifestyles?

The study demonstrated that for the average man and woman, reducing selected health risks results in (1) a postponement of new disabilities; and (2) a decrease in lifetime disability. The health risks studied were smoking, body mass indexes (obesity) and exercise patterns. This finding was true whether the person had a previous disability when entering the study or had no previous disability.

Comment:

It has been feared that improved lifestyle and prevention measures may lead to an expanding population of frail, disabled persons. This study indicates that this isn't true: attention to lifestyle measures can usually result in less lifetime disability. There is every reason to believe that the same is true for persons with cerebral palsy and related developmental neurological disorders. Don't smoke! Stay physically and mentally active! Do appropriate exercises! Avoid obesity! If you do, the chances are greatly improved that you will have more years with less cumulative disability than if you don't. Research data in support of this position is now being reported in the nation's leading research journals. No one is surprised to learn that this is true; however, we now know it is true!

1Aging, Health Risks and Cumulative Disability; Vita, A.J. et al; New England Journal of Medicine, April 9, 1998; 338:15; pages 1035-1041