The premature-aging process and new functional losses among people with chronic disabilities

With continuously increasing longevity among chronically disabled people, we are facing almost near-normal life expectancy for this population. The clinical impression is that some disabled people, as well as people who have undergone extreme stress, age prematurely. Follow-up of chronically disabled individuals often reveals an unexpected and fast deterioration in their mental and physical functioning. Often, we have the impression that some people with disabilities appear to be "older" than their chronological age, as can be seen by their skin, baldness, overweight, posture, etc. Even a trivial insult may lead to such deterioration, in the absence of any detectable "pathological" trigger. This review includes evidence for our hypothesis from certain traumatic events, namely: 1. Premature aging appears also among people with post-traumatic stress disorder (PTSD) and among traumati- cally blind people. 2. Premature aging exists in people who were exposed to extreme stress, captivity, hunger, torture, homelessness or displacement, and among Holocaust survivors. Allostasis and "wear and tear" mechanisms may be responsible for this phenomenon. Proper legislation; modern and comprehensive medical, psychological, and rehabilitation therapies; and humane attitudes toward these populations may decrease signs and symptoms of premature aging and morbidities.