Lifestyle risks for three disease outcomes in spinal cord injury

Object: The majority of research focusing on lifestyle risks in the spinal cord-injured population to date has mainly been descriptive in nature. Limited research has examined the relationships between lifestyle risks and morbidity. This study was undertaken to quantify the associations between selected lifestyle risks and morbidity associated with three top causes of mortality in adults with spinal cord injury (SCI). Method: Ninety-seven adults who had incurred a spinal cord injury between 1972 and 1992 were interviewed over the telephone to assess morbidity and lifestyle exposure history. Logistic regression modelling was used to assess the association between lifestyle risks and cardiovascular, respiratory and urinary tract disorders. Results: Risk of cardiovascular morbidity was found to be positively associated with age and duration of cigarette use. Risk of respiratory morbidity was found to be positively associated with quadriplegia, number of cigarettes smoked per day, and the interaction between cigarettes smoked per day and excessive alcohol consumption. Risk of urinary tract morbidity was found to be positively associated with a complete lesion, number of cigarettes smoked per day and, surprisingly, physical activity. Risk of urinary tract morbidity was negatively associated with monthly alcohol consumption, a traumatic injury and the interaction between monthly alcohol consumption and a complete lesion. Conclusion: With respect to the three morbidity outcomes in this study, cigarette smoking is the most damaging lifestyle behaviour in the spinal cord-injured population. Attention and resources should be directed towards SCI-specific smoking prevention and cessation programmes to prevent the development and exacerbation of chronic diseases in this unique population. Further research is needed to fully understand the associations between lifestyle and chronic diseases in the SCI population.