Participation and Life Satisfaction in Aged People with Spinal Cord Injury: Does Age at Onset Make a Difference?

Abstract

Background: Few studies have reported on outcomes in samples of elderly people with SCI and the impact of the age at onset of SCI is unclear. Objective: To study levels of participation and life satisfaction in individuals with SCI aged 65 years or older and to analyze differences in participation and life satisfaction scores between individuals injured before or after 50 years of age. Methods: This cross-sectional survey included 128 individuals with SCI who were at least 65 years old. Age at onset was dichotomized as <50 or ≥50 years of age. Participation was measured with the Frequency scale of the Utrecht Scale for Evaluation-Participation, and life satisfaction was measured with 5 items of the World Health Organization Quality of Life abbreviated form. Results: Participants who were injured before 50 years of age showed similar levels of functional status and numbers of secondary health conditions but higher participation and life satisfaction scores compared to participants injured at older age. In the multiple regression analysis of participation, lower current age, higher education, and having paraplegia were significant independent determinants of increased participation (explained variance, 25.7%). In the regression analysis of life satisfaction, lower age at onset and higher education were significant independent determinants of higher life satisfaction (explained variance, 15.3%). Conclusion: Lower age at onset was associated with better participation and life satisfaction. This study did not reveal indications for worsening participation or life satisfaction due to an accelerated aging effect in this sample of persons with SCI.

What determines low satisfaction with life in individuals with spinal cord injury?

“…Our findings are similar to those published by Krause and colleagues reporting lower subjective well-being (as a measure of SWL) in persons with SCI who were non-white 4 and Post et al who found that less education was associated with lower SWL. 5 Our finding that individuals who are not-married report lower SWL is consistent with literature describing this finding in the general population. 24 In addition, in individuals with a traumatically acquired disability, being married predicted greater SWL 27 and overall SWL has been found to be higher for individuals with SCI who are married.…”

“…1 Compared with the general population, individuals with SCI report lower SWL. 2 In general, sustaining a more recent injury, of non-traumatic etiology, older age at injury onset, older chronological age, and having more psychological service needs are associated with lower SWL in the SCI population, 3,4 whereas lower age at injury onset, 5 lower levels of pain 6 and pain interference, 7 active lifestyle, 8 and white race 3 are associated with higher SWL. Furthermore, more active participation in self-care practices and better access to care and care coordination with health care providers are associated with higher SWL in individuals with SCI.…”

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

“…This finding indicates that other factors may also be associated with life satisfaction among older adults who have lived with a SCI for many years. Previous research has suggested significant associations with psychological distress and depression [52], sense of coherence [17], perceived health status [52], and community participation [52,54] in individuals with SCI. Furthermore, engagement in physical activity has demonstrated positive effects on life satisfaction [55].…”

Global and domain-specific life satisfaction among older adults with long-term spinal cord injury

“…Post and Reinhart 13 studied life satisfaction and participation in 128 persons with SCI who were all at least 65 years old and investigated differences in relation to age at injury (above or below 50 years of age). This study 13 included older adults with both long-term and short-term injury and showed that longer time since injury was associated with greater life satisfaction. In addition, Krause et al 14 studied changes in life satisfaction among 49 individuals at least 40 years after SCI and mean age of 65 years.…”