Neurogenic Aging After Spinal Cord Injury: Highlighting the Unique Characteristics of Aging After Spinal Cord Injury

J. Clin. Med., 2024 · DOI: 10.3390/jcm13237197 · Published: November 27, 2024

Simple Explanation

Spinal cord injuries can lead to accelerated aging, but this aging process is unique compared to normal aging. It involves distinct patterns of decline in muscles, bones, and hormones, affecting physical function differently. After a spinal cord injury, muscle loss and changes in muscle fiber types occur rapidly. Bone loss develops quickly, increasing the risk of fractures in specific areas. These changes are influenced by nerve damage, leading to what is termed neurogenic accelerated aging. This review focuses on the differences between aging processes in individuals with and without spinal cord injuries. Understanding these differences is crucial for developing interventions to improve outcomes and quality of life for those living with SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Muscle atrophy after SCI involves a rapid shift to type II fast-twitch glycolytic fibers, unlike the typical loss of type II fibers in normal aging. This leads to significant strength and endurance reduction.
2
Bone loss after SCI is rapid and primarily affects the distal femur and proximal tibia, differing from typical age-related bone loss which commonly affects the vertebrae and hip.
3
Individuals with SCI often experience neurogenic obesity characterized by reduced lean mass and increased fat mass, driven by factors such as anabolic deficiency and sympathetic dysfunction.

Research Summary

Individuals with SCI experience a pattern of decline during aging that is different from individuals without SCI. Muscle atrophy and skeletal muscle fiber type transformation occur rapidly and in unique patterns after SCI, resulting in decreased skeletal muscle CSA and a predominance of type II fast-twitch glycolytic fibers. Cardiovascular changes after SCI result in lower exercise heart rates and decreased oxygenation in the body, neuropathically driven dyslipidemia, glucose intolerance, insulin resistance, and a reduced metabolic rate, increasing the risk of cardiovascular disease.

Practical Implications

Exercise Recommendations

Increased physical activity, especially functional electrical stimulation exercises, and resistance training, is crucial for maintaining muscle mass and slowing the effects of neurogenic aging on skeletal muscle.

Bone Health Strategies

Weight-bearing activities during the acute stages post-SCI and vitamin D supplementation can help slow bone loss. A combination of pharmacological, vitamin, and exercise treatments is often recommended.

Cardiometabolic Risk Management

Healthy lifestyle changes, including dietary adjustments and regular physical activity, are essential. Hybrid-type activities and interventions to improve venous blood return to the heart can also mitigate cardiovascular risk.

Study Limitations

1
The precise mechanisms driving neurogenic accelerated aging are still being investigated.
2
More research is needed to optimize therapeutic interventions for individuals with SCI.
3
The long-term effectiveness of various treatments needs further evaluation.

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