Impact of comorbidity and lifestyle related factors on functioning in aging polio survivors
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1 Impact of comorbidity and lifestyle related factors on functioning in aging polio survivors Irene Tersteeg Janneke Stolwijk Anita Beelen Frans Nollet Department of Rehabilitation, University of Amsterdam, Academic Medical Centre, Amsterdam, Netherlands
2 Program 1 Aging 2 Comorbidity 3 Lifestyle related factors 4 Impact of comorbidity and lifestyle related factors on functioning 5 Conclusion and key points
3 1 Aging A complex multidimensional phenomena: - Genetic, biological, physical, psychological, social en environmental factors. - Aging decrease in functional reserves and multi-morbidity.
4 1 Aging Decrease in functional reserves decrease in physical functioning. Lower social and environmental demands less active life style.
5 functional reserves (%) 1 Aging in polio survivors 100 general population polio survivors 50 Problems in functioning age
6 1 Aging Polio survivors age like general population they develop comorbidity. Polio survivors have paresis less able to lead an active life style prone to certain types of comorbidity?
7 Program 1 Aging 2 Comorbidity 3 Lifestyle related factors 4 Impact of comorbidity and lifestyle related factors on functioning 5 Conclusion and key points
8 2 Comorbidity Polio survivors have a higher prevalence of - Cardiovascular disease. - Pulmonary disease. - Endocrine and metabolic disease. - Diseases of the locomotive apparatus. Kang JH, Lin HC. Comorbidity profile of poliomyelitis survivors in a Chinese population: a population-based study. Journal of neurology (2011);258(6): Nielsen NM, Rostgaard K, Askgaard D, Skinhøj P, Aaby P. Life-long Morbidity among Danes with poliomyelitis. Arch Phys Med Rehabil (march 2004): 85; ).
9 2 Cardiovascular disease Ischemic heart disease (OR: 1,20-2,53) Hypertension (OR: 1,51-2,79). Arrhythmias (OR: 1,20-2,40). Possible explanation: lower level of physical activity.
10 2 Pulmonary disease Late onset respiratory failure. Chronic pulmonary disease (OR: 1,54-2,50). Asthma (OR: 1,38-2,98).
11 2 Endocrine and metabolic disease Diabetes (OR: 2,29). Hyperlipidemia (OR: 2,45). Hypothyroidism (OR: 1,73). Gawne AC, Wells KR, Wilson KS. Cardiac risk factors in Polio survivors. Arch phys med rehabil (2003): 84;
12 2 Diseases of the locomotive apparatus Arthrosis (OR: 1,16). Osteoporosis (OR: 2,10). Increased risk of fractures. Mohammad AF, Khan KA, Galvin L, Hardiman O. O Connell PG, High Incidence of Osteoporosis and Fractures in an Aging Post-Polio Population. Eur Neurol 2009;62:
13 Program 1 Aging 2 Comorbidity 3 Lifestyle related factors 4 Impact of comorbidity and lifestyle related factors on functioning 5 Conclusion and key points
14 3 Lifestyle related factors Daily physical activity - Lower in polio survivors. - Associated with muscle strength and experienced pain. Klein MG, Braitman LE, Costello R, Keenan MA, Esquenazi A. actual and perceived activity levels in polio survivors and older controls: a longitudinal study. Arch Phys med Rehabil (2008): 89;
15 3 Lifestyle related factors Excess body weight. - Case-controlled study: higher prevalence of obesity in polio survivors. - No data from population based studies. - How to measure excess body weight? Chang KH, Lai Ch, Chen SC, Hsiao WT, Liou TH, Lee CM. Body composition assessment in Taiwanese individuals with poliomyelitits. Arch Phys Med rehabil 2011;92 (7):
16 Program 1 Aging 2 Comorbidity 3 Lifestyle related factors 4 Impact of comorbidity and lifestyle related factors on functioning 5 Conclusion and key points
17 4 Impact of comorbidity on functioning Few studies have focussed on the impact of comorbidity on functioning in polio survivors. CARPA study.
18 4 CARPA study Prospective follow-up study during 5 years. 168 patients aged with late onset sequelae of poliomyelitis. To study the course of physical functioning and to identify prognostic determinants of change in functioning, with emphasis on the impact of age and comorbidity.
19 4 Results of CARPA study Slow decline in physical functioning in accordance with other studies. Prognostic factors for course of functioning: - Comorbidity. - Extent of paresis. Stolwijk-Swüste JM, Tersteeg I, Beelen A, Lankhorst GJ, Nollet F. The impact of age and co-morbidity on the progression of disability in late-onset sequelae of poliomyelitis. Arch Phys Med Rehabil 2010;91:
20 4 Impact of comorbidity on functioning More comorbidity lower level of functioning. More comorbidity faster decline in functioning. Patient Gender age Arm strength Leg strength Comorbidity score Total FIM at baseline Decline FIM 1 F F
21 4 Impact lifestyle related factors functioning Polio survivors reporting regular physical activity higher functional level. Weight gain risk factor post polio syndrome. Rekand T, Kõrv J, Farbu E, et al. Lifestyle and late effects after poliomyelitis. A risk factor study of two populations. Acta Neurol Scand (2004); 109: Trojan DA, Cashman NR, Post-Poliomyelitis syndrome. Muscle Nerve 2005; 31: 6-19
22 Program 1 Aging 2 Comorbidity 3 Lifestyle related factors 4 Impact of comorbidity and lifestyle related factors on functioning 5 Conclusion and key points
23 5 Conclusion Higher level of comorbidity lower level of functioning and faster decline in functioning in polio survivors. The lifestyle related factors physical inactivity and excess weight are associated with a lower level of functioning in polio survivors.
24 5 Treatment Screening on: - Diabetes, hyperlipidemia, hypothyroidism. - Osteoporosis. - Lung function.
25 5 Treatment Information on: - Weight control. - Daily physical activity. - Prevention of overload of muscles.
26 5 Further research More studies on impact of comorbidity and lifestyle related factors on functioning. Preferable follow-up > 4 years.
27 5.... Irene Tersteeg
Impact of comorbidity and lifestyle related factors on functioning in aging polio survivors
Impact of comorbidity and lifestyle related factors on functioning in aging polio survivors Irene Tersteeg Janneke Stolwijk Anita Beelen Frans Nollet Department of Rehabilitation, University of Amsterdam,
MANY PEOPLE WITH a history of poliomyelitis report
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