More Than Half of Veterans with Spinal Cord Injuries and Disorders Have Greater Perceived Social Isolation Than the General Population

BACKGROUND:
The quantity and quality of social relationships play a key role in mental, behavioral, and physical health. Perceived social isolation (PSI), or loneliness, can heighten the inflammatory response, which in turn can increase the risk of dementia, sleep problems, depression, and other negative cognitive, mental, and physical health outcomes. Veterans with spinal cord injuries and disorders (SCI/D) might have greater risk of PSI due to disability caused by comorbidities or SCI/D secondary health conditions (e.g., bladder and bowel problems) and environmental barriers (e.g., inaccessible surroundings). Identifying factors associated with PSI can help healthcare professionals and other stakeholders identify Veterans at risk for PSI and highlight areas that can be targeted to help Veterans reduce PSI. This study examined PSI among Veterans living with SCI/D, and identified which demographics, injury characteristics, health factors, and objective social isolation measures were significantly associated with high PSI. Researchers surveyed 1,942 Veterans with SCI/D (Oct. 2022–Jan. 2023) who recently used the VA healthcare system and had a valid residential mailing address. Of those, 421 Veterans completed the survey (a 22% response rate).

FINDINGS:

• Over half (56%)of the survey respondents had PSI scores higher than the general population.
• Having a small social network (fewer than four people), depression, anxiety, post-traumatic stress in the previous six months, or four or more chronic SCI/D secondary conditions was associated with increased odds of high PSI.
• The most common Veteran-identified contributors to feelings of PSI included mobility concerns (63%), having a SCI/D (61%), and concerns about being a burden on others (57%).

IMPLICATIONS:

• Factors identified in this study can be used to identify Veterans with SCI/D who are at risk for PSI, and to target those factors with patient-centered interventions to reduce PSI.
• More research is needed on the types of social network (e.g., family, friends, peers) and support (e.g., emotional, informational) that are most beneficial in reducing PSI in Veterans with SCI/D.

AUTHOR/FUNDING INFORMATION:
Ms. Wirth, Mr. Bartle, and Dr. LaVela are located at HSR’s Center of Innovation for Complex Chronic Healthcare (CINCCH) in Hines, Illinois. Mr. Aguina is a Veteran living with SCI/D who served as a study team member and lived experience consultant on this study.




Wirth M, Motl RW, Bombardier CH, Bartle B, Wong AWK, Aguina K, LaVela SL. Factors Associated with Perceived Social Isolation Among Veterans with Spinal Cord Injury and Disorders: Cross Sectional Survey. The Journal of Spinal Cord Medicine. February 5, 2024;online ahead of print.