Article Details

Research Database: Article Details

Citation:  Krause, J.S., Clark, J.M., & Saunders, L.L. (2015). SCI longitudinal aging study: 40 years of research. Top Spinal Cord Injury Rehabilitation, 21 (3), 189-200.
Title:  SCI longitudinal aging study: 40 years of research
Authors:  Krause, J.S., Clark, J.M., & Saunders, L.L.
Year:  2015
Journal/Publication:  Top Spinal Cord Injury Rehabilitation
Publisher:  Thomas Land Publishers, Inc.
DOI:  https://doi.org/10.1310/sci2103-189
Full text:  https://www.ncbi.nlm.nih.gov/pubmed/26363585   
Peer-reviewed?  Yes
NIDILRR-funded?  Yes

Structured abstract:

Background:  Longitudinal studies on the course of Spinal Cord Injury can help rehabilitation professionals understand the natural aging process, impact on health, community participation, and quality of life. Few studies have looked at aging among individuals with SCI. The SCI Longitudinal Aging Study began in 1973. Over the past 4 decades, 8 assessments have been conducted. It is the most long standing study on SCI and aging and has led to more than 50 publications.
Purpose:  The aim of this paper was to provide a history of the study, response patterns, utilization of measures, and a summary of key findings.
Setting:  The setting was a medical university in the eastern United States. The study sample was drawn from eastern and midwestern geographical locations in the United States.
Study sample:  The longitudinal study started with 256 participants. Over the past 40 years, 4 additional samples have been added. A total of 2,208 participants have completed 6,001 assessments. The five samples are from two geographical locations in the US, the midwest and southeast. At the most recent follow up in 2013, the sample size was 759 active participants, with 194 from the midwestern samples, and 565 from the southeast samples. The majority were male (71.9%) and white (71.9%). The average age was 27.3 years at the time of injury and 54.3 years at the time of the study. Around 27.0 years had passed since injury. On average participants had 14.3 years of education. The samples were somewhat different in terms of demographic characteristics based on geographical region. The researchers also broke down the number of historical responses as related to years post injury dating back to 1973. For example, those at 40 years post injury include individuals assessed between 37.5 years and 42.4 years post injury. A total of 5,942 assessments had been completed with a total of 349 assessments at 40 years (n=187); 45 years (n=104) and 50 plus years (n=58) post injury.
Intervention:  There was no intervention. This is a longitudinal study.
Data collection and analysis:  Self report measures were obtained through mail over the years, with little deviation. Extensive efforts were made to locate participants at follow up. Qualitative interviews were conducted in 1974 and the 20 year follow up. The interviews in 1974, with 131 participants, were used to develop a handbook for counselor related to employment after SCI. The follow up interviews 20 years later were conducted with a subsample of 50 of the original participants. The Life Situation Questionnaire was used to obtain information about overall psychosocial, vocational, and medical outcomes of individuals with SCI. Over the years some modifications were made but the core content was maintained. Other measures added included: the Craig Handicap Assessment Report Technique, Berlin Social Support Scales, Older Adult Health and Mood Questionnaire, Brief Pain Inventory, Modified Fatigue Impact and Secondary Health Conditions Checklist (only one in 1993).
Findings:  As individuals with SCI age, patterns of outcomes change. These include some declines in participation and health. The effects of aging and the passage of time, seem to have greatest impact on social and medical outcomes, while employment outcomes were typically maintained. The researchers found that post-injury employment rates exceeded 50%. This was due to a 2 to 1 ration of those who remain employed at any point in time compared to those who lose employment. This points to a need to find ways to improve job retention.Other findings related to predictive factors with post injury employment from their relationship with other qualitative indicators. Another employment outcome was the amount of time between onset of SCI and employment. The average time was 4.8 years with both a fast track (i.e. higher ed, working in professional occupation prior to injury, return to same employer post injury) or slow track to work. These findings emphasized a speedy return to work whenever possible. Related to barriers the researchers found health barriers (i.e. ulcers) were the most significant barriers to future work. Medical and financial disincentives were also indicated among the unemployed, but were not related to the probability of future employment. The researchers noted a survivor effect where the individual seems more active, well adjusted and healthier.
Conclusions:  Data from the study adds to the research about the natural course of aging with SCI.

Disabilities served:  Spinal cord injury (SCI)
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Outcomes:  Employment acquisition
Return to work
Other