There have been a remarkable lack of studies on the impact of aging on the person with a disability due to cerebral palsy. One of the reasons is that the variety of disabilities would probably mean there are a great number of potentially different impacts; another is that there are a wide variety of life styles, all of which have significant impacts on disabilities associated with the aging of all persons; finally, aging is a continuum and the impact is different among age groups (e.g.: the forties, the sixties, the seventies). Despite these difficulties, there are a number of generalities that experience indicates are applicable. The September 18, 1996 UCPA Teleconference on Aging and Cerebral Palsy: Double Jeopardy discussed what we think we know. One of the documents used in the Teleconference was an information sheet prepared by the Ontario Federation for Cerebral Palsy. The following provides some of the information from that source. The disabilities associated with cerebral palsy may result in physical, social and psychological stresses earlier in life for the individuals with cerebral palsy than for the general population.

Physical Stresses increasing joint and muscle pain declining mobility due to bone and muscle mass losses abnormal stress on bones and muscles wear and tear on joints changes in gait and shift in weight-bearing arthritic changes osteoporosis - fractures may be slower in healing decreased endurance increased fatigue spine and joint changes affecting joint and weight bearing increased respiratory problems causing heart and lung complications bowel and bladder problems related to reduced intake of fluids and fibre and reduction in physical activity pressure sores and skin breakdown reduced physical functioning and poor nutrition affecting the function of the cardiovascular system poor dental care in early years and poorly fitting dentures side effects from long term use of medications causing physical problems.

Social Stresses more energy may be required to manage day to day tasks, with less energy left for social activities there may be decreased opportunities for social and leisure activities, causing feelings of isolation there may be a need to reduce working hours or give up employment completely, with a resulting loss of independence.

Psychological Stresses depression in the most common behavioral issue facing the aged population generally; because of accelerated loss of independence in some persons with disabilities, this can be an even greater problem for them depression can be masked by or mistaken for physical illnesses; it can also be caused by illness or by medication Comment: Although the above are broad generalities that may or may not describe individual problems of aging in persons with a disability, they are as good as we have at this time. The key is that these are problems often associated with the aged; persons with developmental disabilities may have some of them earlier in life than persons without developmental disabilities. There are two health issues that require attention: one is a health service issue and the other is a research issue. Too often, physicians and other health care providers who work with aging populations are not comfortable with the knowledge they have in order to deal with the problems of persons who already have a lifelong disability. The American Academy of Cerebral Palsy and Developmental Medicine, a multi-disciplinary professional society, has offered its services to other professional groups to provide their members with seminars and teaching materials about disabilities. Thus, information already available about persons with developmental disabilities will be more readily accessible to all health care professionals. A critical research issue is how to prevent or decrease the accelerated rate of occurrence of disabilities of aging in persons who already having a developmental disability. Major targets for research attention are joint and muscle pain, declining mobility, increased fatigue and depression. These research priorities are being brought to the attention of scientists studying the problem of people with disabilities and to those scientists studying aging. Unfortunately, there are as yet very few scientists working specifically on aging in persons with disabilities. We are trying to make certain that what we already know is being used; also, with an increased emphasis nationally on research on aging, the issue of research on aging in persons with disabilities is not being overlooked.