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.
AGING WITH POLIO --101
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?
Secondary conditions are new health problems, impairments, and functional limitations that occur after the onset of the primary disability and are related to it (directly or indirectly). These secondary conditions can include complications associated with the primary impairment as well as age-related conditions or chronic illnesses (e.g. heart disease, hypertension, osteoporosis, and diabetes). Although these conditions occur in the general population, they may occur more frequently among persons aging with disability because of their reduced mobility and potentially narrower margin of health. Regardless of the exact cause, the significance of secondary conditions stems from their capacity to erode independence, undermine quality of life, and increase need for health-related services.
The "good news" is that many secondary conditions are preventable through early detection and better self-care practices and health habits. Because of the growing numbers of people at-risk and the "costs" (both personal and societal) associated with these conditions, preventing secondary conditions among the elderly and persons with chronic disabilities has become a major public health goal of the 1990s and beyond.
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:
What new health problems and functional limitations do polio survivors report approximately 50 years after acute onset?
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:
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.
Who is most "at-risk" for the secondary health problems and functional changes associated with polio?
What protective influences can we identify that may buffer the impact of "aging" on the health and well being of polio survivors?
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.
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 http://www.usc.edu/dept/gero/RRTConAging/
The Rancho Los Amigos Post-Polio Support Group meets the 4th Saturday,
from 2:00-4:00 in Downey, CA.
Contact: RanchoPPSG@hotmail.com for more information.
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