People with cerebral palsy, as they get older, may experience general health problems at a higher than average rate. The importance of regular health checks leads to early diagnosis and treatment and, consequently, to avoiding long-term complications. For example, among young adults, aged 18 to 30, it is known that 1 in 4 will present multimorbidity and that will increase linearly with age.
Health problems associated with adults with cerebral palsy
The most serious problems of adults with cerebral palsy are:
- Respiratory problems (aspiration pneumonia).
- Oropharyngeal dysphagia (difficulty swallowing).
- Gastroesophageal reflux disease.
These pathologies are usually associated with each other and they appear frequently in people with greater motor impairment. In many cases, these health problems arise in childhood, but tend to persist and worsen in adulthood; when this happens, it is essential to closely monitor nutritional aspects to avoid malnutrition. At the Aspace Catalunya Foundation we have one unit specialized in swallowing and nutrition made up of speech therapists, a rehabilitation doctor with a master's degree in Nutrition and a nurse specialized in nutrition to attend to these needs.
The most common health problem in adults with cerebral palsy is usually chronic constipation, to which aspects such as less mobility, the usual diet and the drugs that are used very frequently in the comprehensive management of the person contribute. Anticholinergics, antiepileptics, antipsychotics, antidepressants, antihypertensives or opioid analgesics, to name a few examples. Chronic constipation, in addition to causing discomfort, can result in fecal impaction that leads to a severe intestinal obstruction.
Obesity, high blood pressure and diabetes mellitus are more common in people with cerebral palsy than in the general population. In determining overweight and obesity, the measurement of abdominal circumferences is more important than the Body Mass Index (BMI), which may underestimate the problem. Periodic analytical controls to detect hyperlipemias are essential. In addition to increasing the risk of cardiovascular problems at an earlier age, being overweight leads to less mobility, which makes sedentarism worse.
It is necessary to monitor the skin of the areas where there is more pressure, the area of the folds, areas of friction and contact points of the urinary collectors. Likewise, it is necessary to monitor chronic drug treatments and rule out drug interactions.
Finally, it is vital to remember the importance of women's health checks and the examinations necessary for the early detection of breast cancer, since, on many occasions, it is not possible to do a mammogram like in the general population.
Health care provided at the Aspace Catalunya Foundation for adults with cerebral palsy
From the Aspace Catalunya Foundation we know from experience that adults with cerebral palsy have more complex problems, which require longer appointments and complementary scans are often difficult to perform.
However, la early detection and clinical diagnosis are fundamental and that is why the rsystematic periodic reviews they are essential to detect problems and be able to initiate preventive actions and therapeutics or direct them to the corresponding specialists.
Bibliography
Seddon PC, Khan Y. Respiratory problems in children with neurological impairment. Archives of Disease in Childhood 2003;88: 75 - 78
