Original article
Males Aging With a Spinal Cord Injury: Prevalence of Cardiovascular and Metabolic Conditions

https://doi.org/10.1016/j.apmr.2011.07.201Get rights and content

Abstract

LaVela SL, Evans CT, Prohaska TR, Miskevics S, Ganesh SP, Weaver FM. Males aging with a spinal cord injury: prevalence of cardiovascular and metabolic conditions.

Objective

To compare the prevalence of cardiovascular and metabolic conditions in male veterans aging with spinal cord injury (SCI) with that of older men comparison groups.

Design

Cross-sectional survey.

Setting

National community dwelling.

Participants

Men 65 years and older (veterans with SCI [n=794] injured at least 20y, veterans [n=13,528], and general population [n=6105]).

Interventions

Not applicable.

Main Outcome Measures

Prevalence of diabetes, myocardial infarction (MI), stroke, and coronary heart disease (CHD).

Results

In older adult men with SCI, prevalences of diabetes, MI, stroke, and CHD were 20.30%, 18.70%, 9.84%, and 15.47%, respectively. The odds for stroke were 1.4 times higher in veterans with SCI than general veterans (P<.05), and there was a trend to higher odds for stroke in men with SCI than in the general population (P=.06). The odds for CHD were significantly lower for veterans with SCI than both comparison groups. Being a past smoker was associated with greater odds for diabetes, MI, and CHD, and being a current smoker was associated with higher odds for stroke. High blood pressure and high cholesterol levels were associated with higher odds for all conditions examined.

Conclusions

Diabetes and MI were most prevalent in older adults, but the presence was similar in men with SCI (vs other men). In older adult men, SCI appeared to be protective of CHD. Stroke was most prevalent in veterans with SCI, and controlling for demographic and risk factors, SCI was associated independently with stroke. These findings may be useful for prioritizing preventive health strategies and planning long-term care for men aging with SCI.

Section snippets

Design

Primary data were collected by using a cross-sectional survey mailed to veterans with SCI. The survey was composed of questions from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) survey. Secondary data from the same period were downloaded from the national CDC BRFSS survey database to provide data for the general veteran population and general population comparison groups. The study was approved by the Institutional Review Board at

Results

The response rate for the SCD-HCQ was 50% (3890 veterans with SCI completed surveys, of 7715 to whom they were distributed). The denominator was adjusted by using an undeliverable rate of 25%, consistent with previous mailings in a similar cohort of veterans with SCI.21 Of 3890 veterans with SCI who responded, exclusions included 304 women, 2350 younger than 65 years, and 442 who were injured less than 20 years. The total number of veterans with SCI included in this report was 794. A total of

Discussion

Researchers are in general agreement that individuals with SCI show atypical aging. Medical and functional changes associated with aging have occurred at an earlier age than in the able-bodied population, and SCI-specific aging changes often may be attributed to the unique physical characteristics of this population.5, 6, 22

Conclusions

As individuals with SCI survive into older ages, many are living with chronic conditions, including conditions of the cardiovascular and metabolic systems, which may have higher prevalences or premature onset. Findings of this study suggest that older adult men with SCI are similar to other older adult men in the prevalence of many cardiovascular and metabolic conditions. Although there was no consistent pattern of cardiovascular and metabolic prevalence in persons with SCI in this study, these

Acknowledgment

We thank the Paralyzed Veterans of America for distributing this survey to their membership.

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    This material is based on work supported by the Spinal Cord Injury Quality Enhancement Research Initiative and the Office of Research and Development, Health Services Research and Development Service of the Department of Veterans Affairs. This paper reflects the authors' opinions and does not necessarily reflect the official position of the Department of Veterans Affairs.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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