Sophie Jörgensen, Kathleen A. Martin Ginis, Susanne Iwarsson, Jan Lexell
Department of Health Sciences, Lund University, SE-221 00 Lund, Sverige. E-mail: sophie.jorgensen@med.lu.se
DOI: 10.2340/16501977-2259

Objectives: To assess the presence of depressive symptoms among older adults with long-term spinal cord injury and investigate the association with sociodemographic and injury characteristics; and to determine how potentially modifiable factors, i. e. secondary health conditions, sense of coherence, coping strategies and leisure-time physical activity, are associated with depressive symptoms.
Design: Cross-sectional study.
Subjects: A total of 122 individuals (70% men, injury levels C1–L5, American Spinal Injury Association Impairment Scale A–D), mean age 63 years, mean time since injury 24 years.
Methods: Data from the Swedish Aging with Spinal Cord Injury Study, collected using the Geriatric Depression Scale-15, the 13-item Sense of Coherence Scale, the Spinal Cord Lesion-related Coping Strategies Questionnaire and the Physical Activity Recall Assessment for people with Spinal Cord Injury. Associations were analysed using multivariable linear regression. Results: A total of 29% reported clinically relevant depressive symptoms and 5% reported probable depression. Sense of coherence, the coping strategy Acceptance, neuropathic pain and leisure-time physical activity explained 53% of the variance in depressive symptoms.
Conclusion: Older adults with long-term spinal cord injury report a low presence of probable depression. Mental health may be supported through rehabilitation that strengthens the ability to understand and confront life stressors, promotes acceptance of the injury, provides pain management and encourages participation in leisure-time physical activity.

Depression is common among people with spinal cord injury (SCI), but little is known about mental health among older adults with long-term injury. We investigated the presence of depressive symptoms and associated factors in 122 people who were at least 50 years old and had been living at least ten years with SCI. The results were encouraging as only 5% had signs of probable depression. Psychological resources, neuropathic pain and participation in physical activity were the strongest explanatory factors for depressive symptoms. The results imply that mental health among older adults with long-term SCI may be supported through rehabilitation that strengthens the ability to understand and confront life stressors, promotes acceptance of the injury, provides pain management and encourages participation in physical activity.