Background

Less adults with cerebral palsy (CP) lives independently, compared to adults without disabilities. Access to personal assistance may help overcome barriers to independent living. Also, little is known about hand function in adults with CP, and the role of hand function in achieving independent living remains unexplored.

Objective

To explore the associations between housing and personal assistance in adults with CP, relative to their hand function, age and sex.

Methods

We conducted a cross-sectional registry-based study of 2304 adults with CP, aged 20-64 years old, from the Swedish CP Follow-up Program and Quality Registry. Logistic regression models were used to estimate odds ratios (ORs).

Results

Almost half (48%) of the adults with CP lived independently, and 35% lived with their parents. Independent living was strongly associated with hand function, age and access to personal assistance. The probability of independent living decreased with increasing MACS levels. The odds for independent living increased with access to personal assistance (OR 13.6, 95% CI 9.5-19.6), age (OR 1.09, 95% CI 1.08-1.10), and was higher in women (OR 1.3, 95% CI 1.0-1.5) than men. In total, 995 (43%) adults received personal assistance. The probability for assistance increased successively with MACS levels to MACS V (OR 5.31, 95% CI 4.79-6.96).

Conclusions

Hand function and access to personal assistance are key predictors of independent living in adults with CP. Promoting hand function and ensuring adequate assistance are essential for improving autonomy and quality of life in adults with CP.