Original article
Fatigue and Aging With a Disability

Presented to the International Society of Quality of Life Research Annual Meeting, October 28, 2010, London, UK.
https://doi.org/10.1016/j.apmr.2011.02.017Get rights and content

Abstract

Cook KF, Molton IR, Jensen MP. Fatigue and aging with a disability.

Objective

To compare self-reported fatigue in 4 disability populations with age-matched, U.S. population norms. We assessed fatigue and age in a sample of individuals with spinal cord injury (SCI), postpolio syndrome (PPS), multiple sclerosis (MS), and muscular dystrophy (MD).

Design

This study used survey responses and published age cohort means for fatigue to test the hypothesis that fatigue would be higher in each of 4 clinical samples than the U.S. population norm. We also hypothesized that, for clinical samples, the mean fatigue reported within age cohorts would be higher than the general U.S. population norms for those age ranges derived in the Patient-Reported Outcomes Measurement Information System (PROMIS).

Setting

Survey responses were collected from participants in the Washington state area.

Participants

Participants (N=1836) were persons with MD (n=337), MS (n=580), Post-polio (n=441), and SCI (n=478).

Interventions

Not applicable.

Main Outcome Measure

PROMIS Depression Short Form.

Results

Individuals with disabilities reported higher levels of fatigue than the normative PROMIS population. In the normative population, self-reported fatigue was substantially lower in age cohorts from middle age to retirement age. However, individuals with disabilities did not demonstrate this age cohort effect.

Conclusions

Individuals with disabilities are not only at greater risk to experience fatigue, but this risk, relative to normative values, increases with age. More research is needed to determine the specific negative impact of fatigue symptoms on functioning in individuals with disabilities as they age.

Section snippets

Participants

Participants were recruited for an ongoing longitudinal study examining the role of secondary conditions in aging with a disability, specifically with MS, MD, PPS, or SCI. Recruitment strategies included advertisements in organization newsletters and websites (eg, Muscular Dystrophy Foundation), and inviting persons in the university's registry of persons with disabilities and other condition-specific registries (eg, SCI Model Systems). In addition, we contacted participants from prior studies

Descriptive Analyses

A total of 2041 surveys were mailed to potential participants and 1877 were returned; 15 of these were excluded (eg, no consent, returned survey after completion of study). Of the retained 1862 surveys, 1836 included responses to the fatigue items (participants were allowed to skip individual items as well as entire scales). Therefore, the overall participation rate for the current study was 90% (1836/2041). Table 1 reports the means and SDs of the demographic and disability-related variables.

Discussion

Fatigue and its measurement is a topic that has gained considerable interest in both geriatric and disability research. This is not surprising when one considers the potential impact of this symptom. In middle-aged and older adults with medical disabilities, self-reported fatigue is associated with worse physical function,23, 24, 25, 26 is equally or more impairing than problems such as pain and gait instability,23, 27 and is an independent predictor of mortality.28 There is also evidence that

Conclusions

Despite the study's limitations, the analyses presented are the first to directly compare levels of fatigue to a large national sample of the general U.S. population. We found, as hypothesized, that individuals with disabilities reported higher levels of fatigue than the normative population. Also, whereas in the general population reported fatigue was substantially lower in older age cohorts relative to middle age, the clinical samples that we studied did not appear to benefit as much from

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    Supported by the Department of Education, National Center on Disability and Rehabilitation Research (grant no. H133B080024).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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