title: Modeling secondary health conditions in adults aging with physical disability.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Washington Medical Center, Seattle, USA.
authors.forename: Ivan R
authors.initials: IR
authors.lastname: Molton
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Terrill
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Smith
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Yorkston
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Alschuler
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
authors.forename: Mark P
authors.initials: MP
authors.lastname: Jensen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009103:Multiple Sclerosis / Q000503:physiopathology*; D009468:Neuromuscular Diseases / Q000503:physiopathology*; D016262:Postpoliomyelitis Syndrome / Q000503:physiopathology*; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D055815:Young Adult
keywords: aging; disability; multiple sclerosis; post-polio syndrome; secondary health conditions; spinal cord injury