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Does Polyneuropathy Reduce Life Expectancy?
Everyone who suffers from polyneuropathy wonders whether the disease will make them die earlier, in addition to the many limitations it brings. I have read the scientific studies on the subject for this article and would like to answer the question: Does polyneuropathy reduce life expectancy?
And if so, what can you do about it?
PEOPLE WITH POLYNEUROPATHY LIVE a bit SHORTER LIVES ON AVERAGE
While researching this subject, I first searched through scientific databases on this question, especially Pubmed. Here I found a study by an American research group that compared the life expectancy of polyneuropathy patients with that of people without polyneuropathy. Health data was collected from everyone in an entire county since 1966 and among the study participants were almost 3000 people who had polyneuropathy. The researchers then compared those who had polyneuropathy with participants who did not.
The average life expectancy of people with polyneuropathy was 80 years. The study participants who did not have polyneuropathy lived to 86 on average.
(You can read the study here: Hoffmann et al. 2015).
I also found two other studies that looked at diabetics. These compared the life expectancy of diabetics with polyneuropathy and diabetics without polyneuropathy (Simoneau et al. 2019, Hsu et al. 2012). Again, a lower life expectancy was observed for those with polyneuropathy.
But does that mean that polyneuropathy is deadly?
POLYNEUROPATHY IS NOT deadly
The fact that people with polyneuropathy pass away earlier does not mean that polyneuropathy is a deadly disease.
The nerve damage caused by polyneuropathy rarely leads to death. This is because it does not affect vital organs. The disease usually limits function in the periphery of the body. This means that the problem first affects the hands and feet and only in later stages the thighs and upper arms. This is bad, but not directly life-threatening.
The disease would be life-threatening if the nerves that supply vital organs were damaged to such an extent that those organs no longer worked and one therefore might pass away. There are different nerve diseases in which this happens. For example, it is possible that the nerves that supply the respiratory muscles or the heart no longer function, and as a result the organs can no longer work properly (as seen in cardiac autonomic neuropathy). However, this rarely happens with polyneuropathy.
The reason for the shorter life expectancy of people with polyneuropathy, therefore, lies elsewhere.
One reason is that people with polyneuropathy are much more likely to suffer from other serious diseases that cause nerve damage. This can be diabetes as well as cancer, alcoholism, kidney damage, and circulatory disorders. These diseases alone reduce life expectancy.
But the scientists mention some other reasons:
People with polyneuropathy had a significantly higher risk of falling and were much more often limited in their mobility. They also had more problems coping with everyday life on their own and more frequent circulatory disorders and heart and lung diseases. In other words, they were physically weak and suffered from diseases related to a sedentary lifestyle.
How can life expectancy be increased in spite of polyneuropathy?
As a therapist, it is not enough for me to know that people with polyneuropathy die earlier. I want to know:
What can be done about it?
In other words, how can life expectancy be increased despite polyneuropathy? Being trained as a Sports Scientist, I look at this question from a medical training perspective. As you probably already know, there is very little that can be done against polyneuropathy with medication. Physical training, however, can cause impressive improvements, even with polyneuropathy. Therefore I would like to show you in this article how you can increase your life expectancy, despite having polyneuropathy, with physical exercise.
To do this, we need to know which problems cause people with polyneuropathy to pass earlier and which can be improved through exercise.
FALLS AND PHYSICAL WEAKNESS diminish LIFE EXPECTANCY
Two problems that almost all people with polyneuropathy have in common are an increased risk of falling and reduced physical capability.
Falls are much more dangerous than most people think - especially at old age. Among those older than 65, falls account for up to one-fifth of emergency hospital admissions (Peel et al. 2011).
Those who fall and are seriously injured often become long-term care patients as a result. This is not only true for the famous femoral neck fracture. Falls are also some of the most common causes of craniocerebral trauma and spinal injuries. Once you suffer such an injury, you often end up in a downward spiral, which unfortunately often ends with you no longer being able to care for yourself and ending up in a nursing home.
Unfortunately, the risk of falling is much higher if you suffer from polyneuropathy. Most people with polyneuropathy know this from their own experience and numerous patients have already told me how they fell.
In order to improve your safety, your life expectancy and especially your quality of life, you should try to reduce the risk of falling as much as possible. At the same time, however, you should remain as physically active as possible. This may seem contraditory at first, because someone who moves is a lot more likely to fall than someone who spends his or her days sitting on the couch.
However, if you stop moving because you are afraid of falling, you will suffer all the consequences of a sedentary lifestyle such as muscle strength and bone stability decreasing. Those in turn make you more susceptible to injury. In addition, movement control deteriorates if you do not exercise enough, which increases the risk of falling. There are also many other negative effects of inactivity, such as weakening the heart and a higher risk of strokes.
So simply not being active anymore to reduce the risk of falling is not an option!
It is much better to do specific exercises to be more stable and reduce the risk of falling.
Balance training protects against falls
TRAINING ONE's BALANCE PROTECTS
Special training for your balance is surprisingly effective. People who have better balance stand more stable and therefore fall less often. This is not only logical but has also been proven in numerous scientific studies.
Statistically, the risk of falling is reduced by about one third through training. However, if you train more then average and therefore improve your balance more, you might reduce your individual risk even more.
One of my elderly patients was so successful that he didn't fall once in the whole year of 2020. This same patient had falled almost every month in 2019 and was hospitalised twice after falling.
Of course, such success stories are not the case for everyone, but it is true for almost everyone that the risk of falling is lower when you are better able to keep your balance and control your movements.
Balance TRAINING HELPS AGAINST SYMPTOMS OF POLYNEUROPATHY
Interestingly, the same training also helps to reduce the symptoms of polyneuropathy. Pain and discomfort are often reduced by balance exercises.
This is because balance training directly targets the nervous system. In order to be able to keep your balance, it is not important to have large muscles and physical strength, but to be able to perceive and control your body accurately - the tasks of the nervous system.
Therefore, if you train your balance, you not only reduce the risk of falling, it might also help with the symptoms of polyneuropathy. This means, this training improves your quality of life, which is just as important as living for a long time.
For detailed information on exercises specifically for polyneuropathy, see the following link:
LESS FITNESS = HIGHER MORTALITY
Falls are not the only physical limitation that reduces life expectancy in polyneuropathy. Another crucial risk factor is that people with polyneuropathy are usually less physically fit.
However, those who are more physically fit live longer and healthier lives. This is especially true if you suffer from a chronic disease. Physical fitness protects you in the long term.
The figure below shows the risk of death as a function of physical fitness and chronic diseases. Here you see so-called MET (Metabolic Equivalents). 1 MET corresponds to energy consumption at rest. 8 MET would therefore be eight times the energy consumption at rest. This corresponds to walking at 8 km/h, for example.
People who are able to move at an exercise intensity of 8 MET (i.e. walk at 8 km/h) have hardly any limitations in their life expectancy, even if they suffer from chronic diseases such as diabetes or high blood pressure.
As you can see in the figure, people who do not manage to reach 8 MET have a significantly higher risk of dying. Those who achieve less than 5 MET have more than twice the relative risk of death as people who achieve more than 8 MET. The same applies to almost all diseases and basically also to healthy people: physical fitness increases life expectancy.
Physical fitness keeps you protected - despite illnesses
THOSE WHO ARE FITTER HAVE BETTER FUNCTIONING ORGANS!
The reason fitter people live longer is that fitness means nothing other than well-functioning organs.
To be physically fit, you need a well-functioning heart, healthy lungs and good blood vessels to bring blood and oxygen to the muscles.
The nervous system, which controls the muscles according to the task at hand, must also function well and becomes more efficient through training. The stability and strength of the bones must also be good in order to be able to utilise the power of the muscles and improves if you train a lot.
Physical fitness is therefore nothing other than an expression of well-functioning organs and thus good health. And even more: if you become fitter, stronger and more efficient through training, your organs will also function better!
For example, if you can walk longer and faster today than a month ago, you have a better functioning heart, better functioning muscles and better functioning blood circulation.
This is why physically fit and active people are more likely to survive, even if they suffer from serious illnesses
THOSE WHO ARE PHYSICALLY FIT ARE LESS LIKELY TO FALL ILL.
That is why the risk for many diseases decreases if you are physically fitter.
This also applies to diseases that one would not have thought of at first. For example, the immune system functions better in fit people, which means that infections take an easier course.
Very fit people therefore get pneumonia much less often, for example. This is because your immune system is able to fight infections in the respiratory tract before they can infect the lungs and develop into a dangerous disease.
Even if you do get pneumonia, fit people have more resources to fight the illness. This is because your lungs are more efficient in the first place and are therefore able to take in enough oxygen to supply your body, even if they are affected by the illness.
Oxygen consumption capacity is the most common measure of endurance capacity in sports science. So the better your endurance, the better your oxygen uptake, the better the function of your lungs and your heart and the blood vessels that transport oxygen from the lungs into the body.
Better fitness means better functioning organs!
PHYSICAL ACTIVITY IS MORE DIFFICULT WITH POLYNEUROPATHY
As you can see,t fit people have a higher life expectancy. So we can expect that better physical fitness improves life expectancy even if you are suffering from polyneuropathy.
Now, of course, it is harder to keep fit if you have polyneuropathy. This is because if you are in pain with every step or if you have problems keeping your balance, you obviously can't exercise as easily as someone without any limitation.
Therefore, I assume that the reduced life expectancy of people with polyneuropathy is in part caused by the fact that people with polyneuropathy are less physically active and therefore less fit. As a result, the organs function less well and heart attacks, strokes, and falls occur more frequently, as well as other problems that come with the lack of exercise.
PHYSICAL FITNESS INCREASES THE QUALITY OF LIFE
But you probably do not only care about increasing life expectancy and polyneuropathy. It is at least as important to maintain QUALITY OF LIFE. And here, too, physical fitness is very important.
A person who is physically fit can do more things than someone who has difficulties with simple everyday things.
For example, someone who is physically fit has no problems climbing stairs or carrying groceries. This makes life easier and allows for more fun activities. Last but not least, you are less likely to need the help of others if you are physically stronger.
So keeping physically fit is not just a health issue. It is not just about living as long as possible. It is specifically about living more comfortably.
You can keep fit despite suffering from polyneuropathy!
So you see that it is important to stay active, especially if you have polyneuropathy.
It is obvious that people with polyneuropathy are less active in everyday life because the disease simply makes life more difficult. This is why it is important to create routines for physical training.
For example, you should set fixed times for training every week and follow a training plan. This makes improvements much more likely.
If you start training despite polyneuropathy, you usually have great success in the beginning. After some time, however, you reach a plateau where you can no longer progress. After all, the disease causes limitations that you can't simply ignore. But don't give up!
Be aware that it is already a huge success if you manage to maintain your current level of fitness despite the polyneuropathy. People who do not exercise slowly but surely become weaker, loose their ability to walk safely and ultimately become less independent. You can at least slow down this process with specific exercises.
EXERCISES YOU CAN DO AT HOME
You can find more information and special exercises for polyneuropathy on my page "Exercises for polyneuropathy".
There you will find numerous exercises as well as all important information about the training. You can easily do those exercises by yourself at home.