Lifestyle behaviors and loneliness in community-dwelling veterans living with spinal cord injuries and disorders

Abstract

Study design: Cross-sectional cohort study.

Objective: To examine lifestyle behaviors independently associated with loneliness among Veterans living with spinal cord injuries and disorders (SCI/D).

Setting: The Veteran Health Administration SCI/D System of Care, including 25 regional SCI/D Centers and associated Hubs.

Methods: A national random sample of community-dwelling Veterans with SCI/D who used VHA healthcare services between 2017-2022 participated in a survey. We assessed unadjusted associations with moderate/high loneliness vs no/low loneliness. Multivariable logistic regression model assessed factors independently associated with moderate/high loneliness.

Results: Among 2466 Veterans with SCI/D, 592 completed surveys (24%). Most participants were male (91%), white (81%), and on average 63 years old. The average injury duration was 18 years; 68% had paraplegia, and 80% had traumatic injuries. Lifestyle behavior factors, including poor sleep hygiene (OR 1.67; p = 0.02), fair/poor eating habits (OR 1.64; p = 0.50), and fewer days of leisure-time activities (OR 0.97; p = 0.01), and demographic and injury variables including having paraplegia (OR 1.99; p = 0.002), being unmarried (OR 2.02; p = 0.001), a greater number of SCI/D secondary conditions (OR 1.27; p = 0.002), and a greater number of poor physical health days (OR 1.02; p = 0.03) were each independently significantly associated with greater odds of moderate/high loneliness.

Conclusion: The comprehensive approach of integrating and promoting healthy lifestyle behaviors such as a healthy diet, improved sleep hygiene, and promotion of leisure activities could have a positive effect on loneliness, especially in individuals with paraplegia, who are unmarried, have a greater number of SCI/D secondary conditions, and experience more days of poor physical health.