{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:52:36Z","timestamp":1791453156480,"version":"4.3.3"},"reference-count":30,"publisher":"American Spinal Injury Association","issue":"4","funder":[{"name":"National Institute on Disability, Independent Living and Rehabilitation Research","award":["90DPCP0009"],"award-info":[{"award-number":["90DPCP0009"]}],"id":[{"id":"https:\/\/ror.org\/05r5c7c30","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Institute on Disability, Independent Living and Rehabilitation Research","award":["90IF0112"],"award-info":[{"award-number":["90IF0112"]}],"id":[{"id":"https:\/\/ror.org\/05r5c7c30","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Institute on Disability, Independent Living and Rehabilitation Research","award":["90IF0015"],"award-info":[{"award-number":["90IF0015"]}],"id":[{"id":"https:\/\/ror.org\/05r5c7c30","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Social participation following spinal cord injury (SCI) is associated with improved quality of life, but it may decline with age. While marital status supports greater social participation, the long-term impact as individuals age remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To identify the relationship of marital status with participation trajectories using 20 years of longitudinal data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a cohort study of 343 participants with SCI who completed a self-report assessment 5 times in 2003, 2008, 2013, 2018, and 2023. Conditional growth models were used to assess trajectories of 4 participation indicators over the 5 repeated measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>At baseline, those married or cohabitating (MC) had more work hours per week, more hours out of bed per day, and more nights away from home last year than those divorced, separated, or widowed (DSW). We did not find significant differences between DSW and single individuals at baseline. Average scores declined across all 4 participation indicators over the 20 years, but the MC's rate of change for days out of the house declined slower compared to DSW. MC individuals also spent more hours out of bed than DSW across all time points, with both groups showing similar rates of decline over time, suggesting that MC individuals maintained a relative advantage despite the overall decrease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study showed declines in participation across all marital status groups, but critically a slower rate of decline for MC individuals, and they maintained higher participation levels at each time of measurement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci25-00091","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:23:05Z","timestamp":1791451385000},"page":"46-55","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Marital Status on 20-Year Participation Trajectories in Individuals with Spinal Cord Injury"],"prefix":"10.46292","volume":"32","author":[{"given":"Devyn E.","family":"Smith","sequence":"first","affiliation":[{"name":"College of Health Professions, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Cao","sequence":"additional","affiliation":[{"name":"College of Health Professions, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brielle D.","family":"Grant","sequence":"additional","affiliation":[{"name":"College of Health Professions, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Krause","sequence":"additional","affiliation":[{"name":"College of Health Professions, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"11","key":"b1","series-title":"Disabil Rehabil","first-page":"894","article-title":"Secondary health conditions and spinal cord injury: An uphill battle in the journey of care","volume":"35","author":"Guilcher SJ","year":"2013","unstructured":"Guilcher SJ, Craven BC, Lemieux-Charles L, Casciaro T, McColl MA, Jaglal SB. Secondary health conditions and spinal cord injury: An uphill battle in the journey of care. Disabil Rehabil. 2013;35(11):894-906. doi:10.3109\/09638288.2012.721048."},{"issue":"12","key":"b2","series-title":"Spinal Cord","first-page":"882","article-title":"Frequency and age effects of secondary health conditions in individuals with spinal cord injury: A scoping review","volume":"51","author":"Jensen MP","year":"2013","unstructured":"Jensen MP, Truitt AR, Schomer KG, Yorkston KM, Baylor C, Molton IR. Frequency and age effects of secondary health conditions in individuals with spinal cord injury: A scoping review. Spinal Cord. 2013;51(12):882-892. doi:10.1038\/sc.2013.112."},{"issue":"9","key":"b3","series-title":"Disabil Rehabil","first-page":"1796","article-title":"Stigma following acquired brain injury and spinal cord injury: Relationship to psychological distress and community integration in the first-year post-discharge","volume":"46","author":"Ownsworth T","year":"2024","unstructured":"Ownsworth T, Mols H, O\u2019Loghlen J, et al. Stigma following acquired brain injury and spinal cord injury: Relationship to psychological distress and community integration in the first-year post-discharge. Disabil Rehabil. 2024;46(9):1796-1806."},{"issue":"15","key":"b4","series-title":"Proc Natl Acad Sci U S A","first-page":"5797","article-title":"Social isolation, loneliness, and all-cause mortality in older men and women","volume":"110","author":"Steptoe A","year":"2013","unstructured":"Steptoe A, Shankar A, Demakakos P, Wardle J. Social isolation, loneliness, and all-cause mortality in older men and women. Proc Natl Acad Sci U S A. 2013;110(15):5797-5801. doi:10.1073\/pnas.1219686110."},{"issue":"7","key":"b5","series-title":"J Rehabil Med","first-page":"jrm00217","article-title":"Participation and quality of life in persons living with spinal cord injury in Norway","volume":"53","author":"Halvorsen A","year":"2021","unstructured":"Halvorsen A, Pape K, Post MWM, et al. Participation and quality of life in persons living with spinal cord injury in Norway. J Rehabil Med. 2021;53(7):jrm00217. doi:10.2340\/16501977-2858."},{"key":"b6","series-title":"International Classification of Functioning, Disability, and Health (ICF).","author":"World Health Organization","unstructured":"World Health Organization. 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The role of social support and social skills in people with spinal cord injury--a systematic review of the literature. Spinal Cord. 2012;50(2):94-106. doi:10.1038\/sc.2011.116."},{"issue":"8","key":"b9","series-title":"Spinal Cord","first-page":"430","article-title":"Longitudinal changes in employment, health, participation, and quality-of-life and the relationships with long-term survival after spinal cord injury","volume":"61","author":"Cao Y","year":"2023","unstructured":"Cao Y, DiPiro ND, Krause JS. Longitudinal changes in employment, health, participation, and quality-of-life and the relationships with long-term survival after spinal cord injury. 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Disabil Rehabil. 2000;22(17):764-775. doi:10.1080\/09638280050200269."},{"issue":"3","key":"b12","series-title":"Rehabil Psychol","first-page":"273","article-title":"A systematic review of how spinal cord injury impacts families","volume":"67","author":"Wilson CS","year":"2022","unstructured":"Wilson CS, DeDios-Stern S, Bocage C, Gray AA, Crudup BM, Russell HF. A systematic review of how spinal cord injury impacts families. Rehabil Psychol. 2022;67(3):273."},{"issue":"3","key":"b13","series-title":"Psychol Aging","first-page":"600","article-title":"Marital closeness, functional disability, and adjustment in late life","volume":"21","author":"Mancini AD","year":"2006","unstructured":"Mancini AD, Bonanno GA. Marital closeness, functional disability, and adjustment in late life. 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J Clin Psychol Med Sett 2001;8(2):101-107."},{"issue":"3","key":"b18","series-title":"Top Spinal Cord Inj Rehabil","first-page":"189","article-title":"SCI Longitudinal Aging Study: 40 years of research","volume":"21","author":"Krause JS","year":"2015","unstructured":"Krause JS, Clark JM, Saunders LL. SCI Longitudinal Aging Study: 40 years of research. Top Spinal Cord Inj Rehabil. 2015;21(3):189-200. doi:10.1310\/sci2103-189."},{"issue":"6","key":"b19","series-title":"Arch Phys Med Rehabil","first-page":"519","article-title":"Quantifying handicap: A new measure of long-term rehabilitation outcomes","volume":"73","author":"Whiteneck GG","year":"1992","unstructured":"Whiteneck GG, Charlifue SW, Gerhart KA, Overholser JD, Richardson GN. Quantifying handicap: A new measure of long-term rehabilitation outcomes. 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