In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 4 ( 2023-4-20), p. e0284420-
Abstract:
As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning. Methods Data from 6’635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants. Results In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning. Conclusions Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0284420
DOI:
10.1371/journal.pone.0284420.g001
DOI:
10.1371/journal.pone.0284420.g002
DOI:
10.1371/journal.pone.0284420.g003
DOI:
10.1371/journal.pone.0284420.g004
DOI:
10.1371/journal.pone.0284420.g005
DOI:
10.1371/journal.pone.0284420.t001
DOI:
10.1371/journal.pone.0284420.s001
DOI:
10.1371/journal.pone.0284420.s002
DOI:
10.1371/journal.pone.0284420.s003
DOI:
10.1371/journal.pone.0284420.s004
DOI:
10.1371/journal.pone.0284420.s005
DOI:
10.1371/journal.pone.0284420.s006
DOI:
10.1371/journal.pone.0284420.s007
DOI:
10.1371/journal.pone.0284420.s008
DOI:
10.1371/journal.pone.0284420.s009
DOI:
10.1371/journal.pone.0284420.s010
DOI:
10.1371/journal.pone.0284420.s011
DOI:
10.1371/journal.pone.0284420.r001
DOI:
10.1371/journal.pone.0284420.r002
DOI:
10.1371/journal.pone.0284420.r003
DOI:
10.1371/journal.pone.0284420.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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