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Longitudinal analyses were used to identify predictors of change in self-rated health (SRH) across an average of 5.2 years for 26 people with spinal cord injury (SCI) and compared to 38 people without disabilities who were matched for chronological age to the SCI sample. Potential predictors of SRH were changes in number of current health conditions, pain, fatigue, functional impairment of activities of daily living (ADLs) and instrumental activities of daily living (IADLs), depression, satisfaction with leisure activities, age, and duration for SCI. Predictors for people with SCI were changes in fatigue, depression, and IADLs. Predictors for the nondisability comparison sample were changes in leisure activities and number of current health conditions. Subsequent analyses were performed with the passage of time between baseline and follow-up measure points (aging) and were added to potential predictors of change in SRH. For people without disabilities, the addition of aging made no difference in the identified predictors of change in SRH. For those with SCI, the passage of time superseded and replaced changes in fatigue and IADLs as predictors of change in SRH, leaving only change in depression as the major predictor of change in SRH. Changes in SRH are predicted by changes in different factors for those aging with SCI versus those without disabilities. Change in depression is a strong predictor for change in SRH in persons with SCI. Although chronological age and duration do not stand out as influencing change in SRH for those with SCI, aging over a 5-year period did influence SRH changes for those with SCI.