The following was first published in the July 1998 Rancho Los Amigos Post-Polio Support Group Newsletter and is reprinted here with kind permission of the author, Mary Clarke Atwood and the Rancho Los Amigos Post-Polio Support Group.


With Margaret L. Campbell, Ph.D.
Summarized by Mary Clarke Atwood

Editorial assistance by V. Duboucheron and M. L. Campbell
Rancho Los Amigos Post-Polio Support Group Newsletter - July 1998

On October 25, 1997, the Rancho Los Amigos Post-Polio Support Group, Downey, California, was privileged to hear Margaret Campbell, Ph.D. report on her research with polio survivors. Since Dr. Campbell is a social scientist, specializing in aging, her approach is very different from that of a medical doctor.

The Changing Disabled Population

Until recently, the public health field wasn't particularly interested in disability. But within the last 10 to 15 years the number of people living with long term disabilities has been increasing dramatically. So disability has become a "growth industry" in terms of health care and in terms of policy. What has caused this change?

The Research

This Aging With Disability Study [Variations In Secondary Conditions, Risk Factors And Health Care Needs For Four Groups Of Persons Aging With Physical Disability] was based on research funded by the National Institute of Disability and Rehabilitation Research, U.S. Department of Education. This research seeks to answer questions about the new health problems polio survivors and other persons with physical disabilities experience as they age and what "survivors" can do to help themselves. The report is based upon responses from 120 polio survivors whose average age at acute onset was about 10 years and 73% of whom were hospitalized. A look at this polio sample reveals:

Question 1:

What new health problems and functional limitations do polio survivors report approximately 50 years after acute onset?

  1. New Health Problems

    On average, polio participants reported a total of 9 secondary health conditions, but less than one-third of these conditions are considered to be leading causes of death. High frequency chronic conditions reported by the polio sample were as follows:
    Hypertension 48%
    Scoliosis 47%
    High Cholesterol 38%
    Obesity 24%
    Depression 24%
    Respiratory Disorder 24%
    Heart Disease 22%
    Osteoporosis 18%
    Hypothyroid 13%
    Diabetes 11%

  2. Functional Impairments

    Level of Functional Impairment
    Difficulty At Physical Best % At Present Time %
        None or Mild
        None or Mild
        None or Mild

    This study also measured both current levels of functional impairment and change in impairment across eight different areas. On average, polio participants reported having current difficulty at the "mild", "moderate", or "severe" levels, with 4.5 of the following functional impairments: muscle weakness, fatigue, pain, breathing, sleep, urinary problems, gait problems and falls. However when current level of impairment was compared to the amount of difficulty respondents experienced at the time of their "physical best" a dramatic difference emerged (see table above). For example, in the area of muscle weakness the percentage of polio survivors reporting "none to mild" dropped from 83% at physical best to only 28% at the present time; whereas, the percentage reporting "severe" difficulty with muscle weakness increased from 4% to 42%. The same pattern also holds for both fatigue and pain.

Question 2:

Who is most "at-risk" for the secondary health problems and functional changes associated with polio?

Question 3:

What protective influences can we identify that may buffer the impact of "aging" on the health and well being of polio survivors?

  1. Informal Social Support (ISS): the number of people providing practical and emotional support.

    • An increase in the number of people providing ISS increases life satisfaction, but only for survivors with "high" levels of current impairment.

    • Women with low levels of ISS appear to assess their health as worse than men with the same low levels of support. (This higher number of respondents approaches significance.)

  2. Social Participation: the number of social roles occupied, such as marriage, parent, worker, volunteer, "best friend", religious attendance, support group attendance.

    • An increase in social roles is associated with an increase in life satisfaction, but only for "lower income" participants.

  3. Self Management Strategies (SMS): the number of approaches used to manage disability related symptoms may include prescribed medications, over-the-counter medications, lifestyle modifications, relaxation and meditation, stretching, exercise, chiropractic, massage, and support group attendance.

    The "benefits" of SMS appear to differ by marital status. For married survivors, an increase in SMS is associated with increased levels of depressive symptoms. Whereas for non-marrieds, practicing high levels of SMS is associated with lower levels of depression.

  4. Religiosity: the presence or absence of current religious affiliation, frequency of attendance, and perceived importance of religion or spirituality in coping with disability.

    • The "benefits" of religiosity on depression appear to differ by support group attendance. An increase in religiosity is associated with a decrease in the number of depressive symptoms, but only for survivors who attend support groups.

The Aging with Disability Study is still in progress. The results of this polio portion will be compared to the results from in-depth interviews with people in three other disability groups: rheumatoid arthritis, stroke and cerebral palsy. Further interpretation will be forthcoming as the research continues.

For more information on the Aging with Disability Study access the Web Site at

Reprinted from Rancho Los Amigos Post-Polio Support Group Newsletter July 1998.
© Rancho Los Amigos Post-Polio Support Group Newsletter and Mary Clarke Atwood

The Rancho Los Amigos Post-Polio Support Group meets the 4th Saturday,
from 2:00-4:00 in Downey, CA.
Contact: for more information.

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