Twenty-Five-Year Cross-sequential Analysis of Self-reported Problems: Findings From 5 Cohorts From the Spinal Cord Injury Longitudinal Aging Study

Objective: To evaluate how self-reported problems change over time among people with spinal cord injury (SCI).

Design: Cross-sequential analysis.

Setting: Medical university in the Southeastern United States.

Participants: Participants included 1997 individuals with traumatic SCI of at least 1-year duration who were identified from participation in the SCI Longitudinal Aging Study from 1993-2018.

Interventions: None.

Main Outcome Measures: The outcomes analyzed were 6 problem factors defined as health, social isolation, emotional distress, environmental barriers, money, and lack of opportunities. A series of cross-sequential models, using PROC MIXED procedure, were developed to evaluate the initial and change of the 6 problem factors over the 6 times of measurements in 25 years.

Results: Years post injury was negatively associated with initial status of problems of social isolation, emotional distress, environmental barriers, and lack of opportunities because participants with more years post injury at baseline reported lower scores on each factor. Longitudinally, with increased years post injury, higher scores were observed on the health problem factor. However, problems of social isolation, emotional distress, environmental barriers, money, and lack of opportunities decreased over time with increasing years post injury.

Conclusions: Participants had more health problems with increasing years after SCI, but fewer problems of social isolation, emotional distress, environmental barriers, money, and lack of opportunities.