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

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. Arch Phys Med Rehabil 2012;93:90-5. 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.