CHANGES IN PHYSIOLOGIC AND HEALTH STATUS IN INDIVIDUALS AGING WITH SPINAL CORD INJURY
Principal Investigators: Robert L. Waters, M.D.; William Bauman, M.D.; Rodney H. Adkins, Ph.D.
Purpose
The purpose of this research is to document and assess physiologic and health status of individuals aging with spinal cord injury, with a special emphasis on cardiovascular disease and to evaluate the relative effects of current age and time since injury.
Methodology
The design and sampling frame re grounded in the establishment of a comprehensive database employing a sequential research design. Participants undergo an annual history and physical with serum profiles including sophisticated lipid profiles. Comprehensive examinations including glucose tolerance and insulin resistance, abdominal ultrasound, pulmonary function testing, bone density and body fat assessment by DEXA. Psychological, support and functional profiles are conducted at five year intervals.
Preliminary Results
Examinations have been performed on 742 participants with
chronological ages ranging from 18 to 83, durations of injury ranging from
one to 57 years, and ages at injury ranging from less than one to 65. Lipid
profiles of spinal cord individuals indicate higher risk at younger ages
than the general population. Levels of HDL cholesterol are significantly
related to residual impairment with complete tetraplegics having the lowest
levels and approximately 40 percent having levels below 35 mg/dL. Regression
analysis indicates age is a more important factor than duration of injury
with regard to most dependent measures. Level of injury, gender, age at
injury and ethnicity are differentially associated with lipid profiles.
Pulmonary function varies with age and level of injury. Bone loss at the
knee is rapid and extreme within 18 months of injury and continues as expected
with age resulting in fracture thresholds being reached at earlier ages
than the general population. Bone density in the lumbar spine of spinal
cord individuals without other mitigating conditions increases with injury
duration.