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Secondary Health Conditions, Activity Limitations, and Life Satisfaction in Older Adults With Long-Term Spinal Cord Injury

JORGENSEN S; IWARSSON S; LEXELL J
PM & R , 2017, vol. 9, n° 4, p. 356-366
Doc n°: 182728
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.pmrj.2016.09.004
Descripteurs : AE21 - ORIGINE TRAUMATIQUE, JF - QUALITE DE VIE

Many individuals with a spinal cord injury (SCI) have lived several decades with their injury, leading to a need for a deeper understanding of
factors associated with healthy aging in people with long-term SCI. OBJECTIVES:
To (1) describe secondary health conditions, activity limitations, and life
satisfaction in older adults with long-term SCI, and to (2) investigate how
sociodemographics, injury characteristics, and secondary health conditions are
associated with their activity limitations and life satisfaction. DESIGN: Cross-sectional descriptive cohort study. SETTING: Home and community settings.
PARTICIPANTS: A total of 123 individuals (71% men, injury levels C1-L5, American
Spinal Injury Association Impairment Scale A-D), mean age 63 years, mean time
since injury 24 years. METHODS: Baseline data as part of the Swedish Aging with
Spinal Cord Injury Study. Associations between variables were investigated with
multivariable linear regression analyses. MAIN OUTCOME MEASUREMENTS: Bowel and
bladder function, nociceptive and neuropathic pain, spasticity, the Spinal Cord
Independence Measure, third version, and the Satisfaction With Life Scale.
RESULTS: Bowel-related and bladder-related problems were reported by 32% and 44%,
respectively, 66% reported moderate or severe nociceptive and/or neuropathic
pain, and 44% reported spasticity. Activity limitations were moderate (mean
Spinal Cord Independence Measure, third version, total score 65.2, range 8-100)
where injury characteristics and spasticity explained 68% of the variance. Higher
level and more severe SCI (based on the American Spinal Injury Association
Impairment Scale) exhibited the strongest association with more activity
limitations. Life satisfaction was rated just above the midpoint between
satisfied and dissatisfied with life (mean Satisfaction With Life Scale total
score 20.7, range 6-34). Marital status, vocational situation, bladder function
and injury characteristics explained 38% of the variance, where having a partner
showed the strongest association with greater life satisfaction. Activity
limitations and life satisfaction were not associated with gender, age and time
since injury. CONCLUSION: Older adults with long-term SCI can maintain a
relatively high level of physical independence and generally are satisfied with
their lives, regardless of gender, age or time since injury. The associations
demonstrate the importance of injury characteristics for the performance of daily
activities and the social context for life satisfaction in older adults with long-term SCI.
LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS

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