Risk factors for functional deterioration in a cohort with late effects of poliomyelitis: A ten-year follow-up study.

BACKGROUND: More than 7000 patients developed poliomyelitis during the main epidemic in the fifties in Israel. In recent years, there is a further deterioration in their condition due to accelerated aging process and post-polio syndrome. OBJECTIVE: To evaluate the risk factors for the progression of functional status in a cohort of patients with late effect of poliomyelitis over a period of ten years. METHODS: A cross-sectional cohort study including 82 individuals with late effect of poliomyelitis evaluated over ten years. Mean age was 67±8.5 years, 52.4%were men and 79.3%were Jewish. Functional status was evaluated by activities of daily living (ADL) questionnaire. Risk factors, including general comorbidities, history of poliomyelitis infection, use of assistive devices, employment, and physical activity statuses were evaluated using specific questionnaires. RESULTS: Independence in ADL functions deteriorated significantly over ten years. Older age, ethnicity, use of a wheelchair, and use of orthotic devices in childhood were risk factors for deterioration in ADL function. No correlation was found between the presence of other comorbidities or poliomyelitis parameters and worsening of ADL functions. CONCLUSIONS: Late effect of poliomyelitis was associated with deterioration in ADL functions probably due to the combined effect of the initial severity of the paralytic poliomyelitis symptoms and accelerated aging.

[DISEASE SEVERITY AND PSYCHOLOGICAL HEALTH AMONG POLIOMYELITIS PATIENTS IN JERUSALEM - 10 YEARS FOLLOW-UP STUDY].

INTRODUCTION: More than 7000 patients contracted poliomyelitis (polio) during the major epidemic in the fifties in Israel. In recent years, there is further deterioration in their condition due to the accelerated aging process and post-polio syndrome. OBJECTIVES: To evaluate the correlation between disease severity, functional and psychological parameters among polio patients in Jerusalem over a period of 10 years. METHODS: A total of 145 polio patients were included in the study; 82 of them were evaluated 10 years ago. The severity of polio sequelae was evaluated using the Index of Post-Polio Sequelae (IPPS) and the psychological status was evaluated using the General Health Questionnaire (GHQ), Hope and Satisfaction with Life scales. RESULTS: The mean age of our sample was 66.4 ± 8.0 years as compared to 57.8 ± 12.8 years in the previous study; 75.9% were Jewish and 28.3% were employed as compared to 75% and 37.3% in the previous study. The severity of polio symptoms according to the IPPS increased and more patients needed assistance in ADL as compared to the previous study, whereas the GHQ score was unchanged. The condition of non-Jewish polio patients was worse as compared to their Jewish counterparts. CONCLUSIONS: The severity of long standing polio symptoms increased with age in correlation with the reduced level of independence in ADL functions. Polio patients have emotional resilience albeit their physical deterioration and work is a significant source of emotional strength. DISCUSSION: Long standing poliomyelitis has a significant effect on patients' health even after many years. The disease contributes to accelerated aging and therefore there is a need for special rehabilitation programs including vocational training in order to prevent further functional deterioration in this population.