Which health problems are most common for people aging with physical disabilities?

A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

As the population ages, many people are growing older with physical disabilities they were either born with or acquired when they were younger, such as muscular dystrophy (MD), multiple sclerosis (MS), or spinal cord injury (SCI). In the general population, people have a higher risk of developing chronic health problems such as heart disease and cancer as they get older. Older adults with physical disabilities may have an even higher risk of health problems than their peers without disabilities for various reasons, including limited mobility and barriers to healthcare. In a recent NIDILRR-funded study, the researchers wanted to find out how common five chronic health problems are for adults with physical disabilities and the age range when these health problems first developed. The researchers also wanted to know who might be at highest risk for developing these health problems.

Researchers at the Rehabilitation Research and Training Center on Aging with a Physical Disability sent two surveys to about 1,600 adults with physical disabilities throughout the United States. The participants had either MD, MS, post-polio syndrome, or SCI. The participants ranged in age from 23 to 97 years old.

The two surveys were sent 3.5 years apart. On each survey, the participants were asked if they had ever been diagnosed with one or more of five chronic health problems: high blood pressure, arthritis, cancer, diabetes, or coronary artery disease, a type of heart disease. The participants also answered questions about their height, weight, and waist size, as well as their alcohol consumption, smoking, and exercise habits.

For each health problem, the researchers looked at the percentage of participants who said they had been diagnosed on each survey. They also looked at how many participants were diagnosed with a new health problem during the 3.5 years between surveys.

The researchers found that:

  • The five chronic health problems were fairly common: Most of the participants (64%) had at least one health problem by the time of the first survey, and 70% did by the second survey. The most common health problems were arthritis (46% of the total sample) and high blood pressure (44%), followed by cancer (20%) and diabetes (10%). Only 7% of the participants had coronary artery disease.
  • New health problems developed over time: In the 3.5 years between the two surveys, 16% of the participants developed a new case of arthritis, 9% developed a new case of high blood pressure, 7% developed a new case of cancer, 3% developed a new case of diabetes, and 2% developed a new case of coronary artery disease.
  • Late midlife was a riskier time for new health problems: Participants in their mid-50s and early 60s were more likely to develop coronary artery disease and cancer than either older or younger participants.
  • Health problems tended to cluster: Among the participants who reported health problems, 56% had at least two, and 19% had at least three.
  • Weight was a risk factor for some health problems: The participants with larger body mass index (BMI) were more likely to develop diabetes during the study, and those with larger waists were more likely to develop both diabetes and cancer.
  • There was a connection between alcohol use and diabetes: Surprisingly, the participants who reported a diagnosis of diabetes were less likely to use alcohol, though the difference in alcohol use between those with and without diabetes was small.

According to the authors, compared to the US general population, arthritis, high blood pressure, diabetes, cancer, and coronary artery disease were slightly more common among the participants in this study than in similarly-aged adults without disabilities. This is consistent with past research on chronic health problems and aging with a disability. Older adults with disabilities may benefit from lifestyle counseling and preventive screenings to detect early signs of health problems before they get worse. This preventive care may be especially important for adults in their 50s and early 60s and for those who have already been diagnosed with a chronic health problem. It may be especially useful to address health and lifestyle factors that people can control, such as their weight and waist size. Clinicians and researchers can work together to adapt evidence-based wellness programs so that they meet the unique needs of older adults with disabilities.

To Learn More

The RRTC on Aging with a Physical Disability has many factsheets and articles for people with disabilities and their healthcare providers. Learn about increasing physical activity, getting better rest, and working with getting the most out of healthcare visits. All factsheets and research summaries are available at: http://agerrtc.washington.edu/info

The Living Well with a Disability Program is a ten week peer-facilitated health promotion workshop for people with disabilities.  Participants in the program learn the life skills they need to set and achieve quality-of-life goals and the important role health plays in helping them reach their dreams. http://livingandworkingwell.ruralinstitute.umt.edu/living-well-program/

The National Center on Health, Physical Activity, and Disability offers a wealth of information on physical activity, nutrition, and health. From starting a health and wellness program (14 Weeks to a Healthier You) to information on modified sports, NCHPAD has something for you! http://www.nchpad.org

To Learn More About this Study

Smith, A. E., Molton, I. R., and Jensen, M. P. (2016) Self-reported incidence and age of onset of chronic comorbid medical conditions in adults aging with long-term physical disability. Disability and Health Journal, 9, 533-538. This article is available from the NARIC collection under Accession Number J73897.

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