Late Effects of Poliomyelitis for Survivors and Physicians

Aging

Due to recent advances in medical rehabilitation, emergency medicine, and consumer education, for the first time in history persons with significant disabilities, like their nondisabled counterparts before them, are surviving long enough to experience both the rewards and challenges of mid- to later-life (Ansello & Eustis, 1992). 

Aging with polio has not come without its costs. In exchange for the personal benefits of increased longevity, many polio survivors, as they age, experience the onset of new, and frequently unexpected, health problems and functional changes that threaten to erode independence and reduce quality of life (Campbell et al., 1994; Maynard et al., 1991). The primary focus has been on the cluster of new polio-related symptoms, most commonly characterized as muscle weakness, fatigue, and muscle or joint pain, resulting in loss of function (see Post-polio Syndrome). The health risks are not limited to these symptoms. Living with the long-term effects of polio also places survivors at potentially increased risk for age-related chronic diseases and health conditions, such as diabetes, high blood pressure, heart disease, emphysema or COPD (chronic obstructive pulmonary disease), osteoporosis, and obesity, to name just a few (Maynard et al., 1991). While these conditions affect the rest of the aging population, they may occur more frequently, and at younger ages, for persons with physical disabilities because of their “narrower” margin of health and the barriers they face in maintaining their health (DeJong, 1995; Marge, 1988; Pope & Tarlov, 1991). 

The significance of both post-polio syndrome and early onset age-related chronic diseases lies in their potential to accelerate the aging process and produce secondary disabilities (Lollar, 1994). Because of the costs of these consequences for individuals as well as society, preventing the new health risks of aging with polio, and other long-term disabilities, has become a major public health objective of the 21st century (Healthy People 2010:  Draft for Public Comment, 1998). 

The Aging with Disability Survey Study tested for evidence of accelerated aging by comparing the frequency of selected chronic conditions reported by 218 polio participants with national estimates of these same conditions for age-matched cohorts from the 1994-95 National Health Interview Survey. From the 14 chronic conditions examined in both studies, polio survivors reported significantly higher rates for almost all mortality and morbidity diagnoses compared with the national estimates. This pattern is most pronounced for the youngest group (45 to 64) where frequencies of chronic conditions are two to ten times greater for those aging with polio than for their same-age counterparts in the population at large (Campbell, 1999). 

These findings document the health problems of persons aging with polio and highlight their changing needs for health care. To reduce the risks of accelerated aging, persons aging with polio need more preventive services and at younger ages; more informed medical and allied health providers who are knowledgeable about the new health risks associated with aging with disability; and more health promotion education.