Self-reported incidence and age of onset of chronic comorbid medical conditions in adults aging with long-term physical disability.

TitleSelf-reported incidence and age of onset of chronic comorbid medical conditions in adults aging with long-term physical disability.
Publication TypeJournal Article
AuthorsSmith AE, Molton IR, Jensen MP
JournalDisabil Health J
Date Published2016 Feb 18

BACKGROUND: Adults with long-term disability are living longer and may experience accelerated aging. More information is needed to understand the incidence of chronic comorbid medical conditions in this population. OBJECTIVE: To examine the incidence, prevalence, age of onset and predictors of five chronic conditions in a sample of adults with long-term physical disability. METHODS: Longitudinal self-report surveys were mailed to 1594 adults with multiple sclerosis, muscular dystrophy, post-polio syndrome or spinal cord injury twice, 3.5 years apart. Survey questions assessed demographics (date of birth, sex, income, disability type, height/weight), self-reported diagnosis of coronary heart disease, hypertension, arthritis, diabetes and cancer, and health behaviors (alcohol use, smoking, physical activity). RESULTS: Over the course of the study, the most commonly reported new onset chronic comorbid medical condition was arthritis (percent incidence = 14%), followed by hypertension (9%) and cancer (7%). Report of a new condition was greatest in adults aged between 56 and 65 years, and risk factors included greater BMI, waist circumference, and the presence of another chronic comorbid medical condition at baseline. CONCLUSIONS: Chronic comorbid medical conditions are prevalent in persons with long-term physical disability. Midlife appears to be the period of greatest risk for onset of a new condition, and risk for incidence increases in the presence of other chronic comorbid medical conditions. Modifiable risk factors include BMI and waist circumference. Future research should explore whether changes in modifiable factors at midlife or earlier (e.g., diet, exercise) would help prevent or delay onset of comorbid conditions in this population.

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What was this research about?

As we get older, we are more likely to develop health problems like arthritis and heart disease. Older adults with long-term physical conditions, such as multiple sclerosis or muscular dystrophy, can face more of these health problems than their peers without such conditions. In this research, we wanted to find out how common five health problems are among adults with long-term physical conditions and what age they tend to get these health problems. We also wanted to find out what distinguishes those who develop health problems from those who do not.

What did the researchers do?

We sent two surveys to about 1,500 people with either muscular dystrophy (MD), multiple sclerosis (MS), post-polio syndrome (PPS), or spinal cord injury (SCI). The surveys were sent about 3 years apart. On both surveys, we asked participants if they had ever been diagnosed with arthritis, high blood pressure, cancer, diabetes, or heart disease. We were especially interested in seeing how many participants developed a health problem between the two surveys. We also asked questions about other things related to health, such as height and weight, waist size, and habits with exercising, drinking alcohol, and smoking.

What did the researchers find?

Most of the participants said they had at least one of the five health problems. The most common health problems were arthritis and high blood pressure, and the least common condition was heart disease. Overall, participants with long-term physical disabilities reported slightly greater rates of chronic health problems, than adults without physical disabilities. About one in six participants who did not yet have arthritis developed it during the three years between surveys, and about one in five participants developed a new case of cancer or high blood pressure. People most commonly developed heart disease or cancer in their 50’s and early 60’s.

People with larger waists were more likely to get cancer or diabetes, and people who with a higher BMI (body mass index) were more likely to get diabetes. People who already had one health problem at the beginning of the study were much more likely to get other health problems over the following three years. More frequent drinkers were less likely to get diabetes, a finding that should be studied further.

How can you use this research?

If you have a long-term physical condition like MS or MD, you might have a higher risk for health problems like arthritis or high blood pressure. The risk is highest for people in their 50’s and early 60’s, so taking good care of your health is especially important during this time in your life. In particular, managing your weight through exercising and following a healthy diet can help prevent health problems.

Things you should know:

Original Research Article:

Smith AE, Molton IR, Jensen MP. Self-reported incidence and age of onset of chronic comorbid conditions in adults aging with long-term physical disability. Disabil Health. 2016 Feb 18 [epub ahead of print].

PubMed ID27009420