Abstract
BackgroundOlder persons may suffer more from travel-related health problems because of ageing and underlying chronic disorders. Knowledge on who is more likely to have these health problems helps to tailor travel health advice more specifically. This study aimed to determine predictors of travel-related morbidity in older travellers by assessing their pre-travel characteristics and performance using physical and cognitive functioning tests.MethodsMulticentre prospective cohort study among older travellers (≥60 years) who consulted one of the participating Dutch travel clinics. Handgrip strength and cognitive performance were measured pre-travel. Participants completed questionnaires before departure and 1 and 4 weeks after return. A diary recorded health complaints during travel until 2-week post-travel.ResultsIn total, 477 travellers completed the study (follow-up rate of 97%). Participants’ median age was 66 years. The most visited regions were South-East Asia (34%) and South Asia (14%). Median travel duration was 19 days. Polypharmacy (≥5 medications per day) was not uncommon (16%). The median Charlson Comorbidity Index (CCI) score was 0. Self-reported travel-related infectious diseases concerned primarily respiratory tract infections (21%) and gastroenteritis (10%) whereas non-infectious complaints were injuries (13%), peripheral edema (12%) and dehydration (3%). Medical assistance was sought by 18%, mostly post-travel from their general practitioner (87%). Self-reported physical and mental health-related quality of life significantly improved during and after travel. Predictors for an increased risk of travel-related morbidity were higher CCI score, more travel experience, longer travel duration, higher number of daily medications, visiting northern Africa or South-East and East Asia, and phone and social media use.ConclusionOlder Dutch travellers are generally fit, well-prepared and suffer not only from common infectious health problems, but also from injuries. Travel improved their self-perceived health. The predictors could be used to identify the more at-risk older traveller and to decrease travel-related morbidity by optimizing pre-travel advice.
Highlights
IntroductionIncrease in life expectancy and vitality has led to a growing older population traveling internationally. In previous studies 15–30% of all international travellers were older adults. Between 1995 and 2017, the percentage of Dutch travellers to tropical destinations has almost doubled from 8% to 16%.5 It is conceivable that this holds true for older travellers.The travel-related morbidity of older travellers is expected to differ from that of younger travellers due to physiological, medical and behavioural differences. Due to their altered homeostasis older persons may suffer more from exposure to extreme climate and environmental conditions, potentially resulting in increased susceptibility to dehydration and hyperor hypothermia. In addition, older persons are more susceptible to infections due to impaired immune responses, waning immunity and limited effectiveness of pre-travel vaccinations. polypharmacy and underlying chronic disorders, including cardiovascular disease, diabetes mellitus (DM) and chronic respiratory diseases are more prevalent among older persons. This poses a risk of decreased physical functioning, drug-related side effects and drug–drug interactions or exacerbations of pre-existing illnesses during travel. Yet, older travellers choose different, possibly lower-risk destinations and travel modes and show less risky behaviour, which may diminish their travel-related health risks. ,
Travellers were generally fit with an overall median 6CIT total score of 0 (IQR 0–2) and a median grip strength of 34 kg (IQR 28–45) (Table 1)
We found that a higher Charlson Comorbidity Index (CCI) score and higher number of daily medications, and more tropical experience, longer travel duration, traveling to Northern Africa or South-East and East Asia, and phone and social media use were associated with higher odds for travel-related morbidity
Summary
Increase in life expectancy and vitality has led to a growing older population traveling internationally. In previous studies 15–30% of all international travellers were older adults. Between 1995 and 2017, the percentage of Dutch travellers to tropical destinations has almost doubled from 8% to 16%.5 It is conceivable that this holds true for older travellers.The travel-related morbidity of older travellers is expected to differ from that of younger travellers due to physiological, medical and behavioural differences. Due to their altered homeostasis older persons may suffer more from exposure to extreme climate and environmental conditions, potentially resulting in increased susceptibility to dehydration and hyperor hypothermia. In addition, older persons are more susceptible to infections due to impaired immune responses, waning immunity and limited effectiveness of pre-travel vaccinations. polypharmacy and underlying chronic disorders, including cardiovascular disease, diabetes mellitus (DM) and chronic respiratory diseases are more prevalent among older persons. This poses a risk of decreased physical functioning, drug-related side effects and drug–drug interactions or exacerbations of pre-existing illnesses during travel. Yet, older travellers choose different, possibly lower-risk destinations and travel modes and show less risky behaviour, which may diminish their travel-related health risks. , . Polypharmacy and underlying chronic disorders, including cardiovascular disease, diabetes mellitus (DM) and chronic respiratory diseases are more prevalent among older persons.18–23 This poses a risk of decreased physical functioning, drug-related side effects and drug–drug interactions or exacerbations of pre-existing illnesses during travel.. Predictors for an increased risk of travel-related morbidity were higher CCI score, more travel experience, longer travel duration, higher number of daily medications, visiting northern Africa or South-East and East Asia, and phone and social media use. Conclusion: Older Dutch travellers are generally fit, well-prepared and suffer from common infectious health problems, and from injuries The predictors could be used to identify the more at-risk older traveller and to decrease travel-related morbidity by optimizing pre-travel advice
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