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Age and spinal cord injury: an emphasis on outcomes among the elderly
John David Putzke1, John J Barrett, J Scott Richards
1Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Objectives:
Determine the unique effects of age across a variety of outcome domains following spinal cord injury (SCI).
Design:
Cross-sectional; 6132 individuals with traumatic onset SCI in the National Spinal Cord Injury Statistical Center (NSCISC) database.
Outcome Measures:
Functional Independence Measure (FIM), Satisfaction With Life Scale (SWLS), the Craig Handicap Assessment and Reporting Technique (CHART), and the Short Form-12 (SF-12).
Results:
Older age was most consistently associated with decreased self-reported outcomes across most domains assessed. More specifically, a significant linear decline with age was found for functional independence (FIM), overall life satisfaction (SWLS), perceived physical health (SF-12 physical health), and overall handicap (CHART-total score), particularly in the areas of physical independence, mobility, occupational functioning, and social integration (CHART subscales). However, regression analyses, controlling for numerous demographic and medical characteristics, indicated that the amount of unique variance that could be specifically attributed to age was relatively small. Age was unrelated to self-reported mental health (SF-12 mental health subscale) and economic functioning (CHART-economic self-sufficiency subscale). Pain interference in day-to-day activities (ie, a single item from SF-12) significantly increased with age.
Conclusion:
There is a small but consistent decline with age in several outcome domains following SCI. Follow-up longitudinal studies should help tease a part possible cohort effects from the effects of age.