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Modeling secondary health conditions in adults with long-standing disabilities


Molton IR, Terrill A, Yorkston K, Alschuler K, Ehde D, Smith A, Jensen MP



Publication Info:

Journal of Health and Aging, 26(3):335-359


OBJECTIVES: To test a conceptual model of secondary health conditions, age, and function in persons aging with long-term physical disabilities.
METHODS: Surveys were collected from 1,862 adults with spinal cord injury, neuromuscular disease, multiple sclerosis, or post-polio syndrome. Structural equation modeling was used to build a model describing relationships among physical and psychosocial secondary health conditions, pain, functional impairments, chronic medical conditions, and age.
RESULTS: In total, 12 individual symptom or function domains (latent factors) were identified, grouped into 5 broader factors. Increasing age was associated with greater rates of physical and health problems and poorer function, and showed curvilinear relationships with pain and psychosocial difficulties.
DISCUSSION: These data support a biopsychosocial model of secondary health conditions in adults aging with physical disability and suggest a five-factor approach for conceptualizing secondary conditions and their impact. Results also emphasize the importance of age in symptom severity and impact.

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