The life expectancy of people with cerebral palsy is complicated as it is a non-progressive condition resulting from specific injury to a baby’s developing brain. Depending on the area of the brain damaged, the symptoms and the severity of the condition will vary.
The injury to the brain will not, in itself, affect how long someone with cerebral palsy will live for, but other health conditions associated with cerebral palsy can reduce life expectancy. Those with more severe conditions are generally thought to have a lower life expectancy.
What factors reduce life expectancy in those with cerebral palsy?
Large-scale studies of children and adults with cerebral palsy in the US indicate two key factors that influence life expectancy – their mobility and ability to feed.
People with cerebral palsy who are able to walk unaided, or roll/sit, generally have longer life expectancy than those who have very limited mobility. This is because those with limited mobility are generally weaker, and will find it harder to fight illness and infection. They are also more dependent on the care of others to help prevent life-threatening illnesses and accidents.
People with feeding problems, such as difficulty chewing and swallowing, are more susceptible to choking and aspiration. This increases the risk of life-threatening conditions such as pneumonia. If their condition is more severe, they will be dependent on others for preventing choking and also for their nutrition.
It therefore follows that the quality of care provided to those with cerebral palsy is also a relevant factor in life expectancy.
Other factors affecting life expectancy for people with cerebral palsy include epilepsy, weight management and respiratory conditions.
Statistics can only ever be a guide and factors affecting how long someone will live for vary.
How is life expectancy estimated for the purposes of calculating compensation in the UK?
Parents of children with cerebral palsy and those suffering cerebral palsy are naturally interested in their life expectancy; and if you’re pursuing a clinical negligence claim, an estimate of life expectancy is necessary to calculate the compensation for lifetime needs.
The generally accepted starting point for estimating life expectancy is to consider American research and statistics:
- Strauss DJ, Shavelle RM, Rosenbloom L, Brooks JC (2008). Life expectancy in cerebral palsy: An update. Developmental Medicine & Child Neurology, 50:487-493
- Brooks JC, Strauss DJ, Shavelle RM, Tran LM, Rosenbloom L, Wu YW (2014). Recent trends in cerebral palsy survival. Part II: individual survival prognosis. Developmental Medicine & Child Neurology, 56:1065-1071
This research estimates life expectancy for those with cerebral palsy at ages 15, 30, 45 and 60 based on the person’s mobility and feeding ability.
In respect of mobility, the different categories of abilities are:
- Cannot lift head
- Lifts head or chest
- Walks unaided.
In respect of feeding, the different categories of abilities are:
- Fed by others
- Self-feeding (further defined as self-feeding for at least 10% of the time).
In order to estimate life expectancy, the statistics in the Strauss tables are adopted for the appropriate abilities, and at the closest age.
For example, a 15-year-old female with cerebral palsy who is self-feeding, but cannot walk unaided, would have an estimated life expectancy of 48 years from age 15 (age 63). This is compared with the life expectancy for the general population, which is an estimated 66 years from age 15 (age 81).
Statistics based on mobility and feeding can then be adjusted for other factors, such as epilepsy.
The Strauss statistics relate to the US population. There are no equivalent statistics available for people with cerebral palsy in the UK and general life expectancy statistics vary between the US and UK.
So how do we apply US research for the purpose of calculating the costs of future lifetime needs in a clinical negligence claim for cerebral palsy in the UK?
The accepted method is to compare, as a percentage, the two estimated life expectancies provided in the American studies and then apply this percentage to the relevant UK life expectancy statistics, published by the Office of National Statistics.
- A 15-year-old American girl with cerebral palsy who feeds herself, but cannot walk unaided, has an estimated life expectancy of a further 48 years versus a further 66.2 years estimated for the general population.
- She will, therefore, reach 72.5% of the life expectancy estimated for someone the same age without cerebral palsy.
- We apply 72.5% to the life expectancy of a 15-year-old girl in England and Wales (as published by the UK Office of National Statistics) to obtain the estimated life expectancy for a 15-year-old girl with cerebral palsy who feeds herself, but cannot walk unaided.