The Impact of Age on Mortality, Impairment, and Disability among Adults with Acute Traumatic Spinal Cord Injury

JOURNAL OF NEUROTRAUMA, 2009 · DOI: 10.1089=neu.2009.0888 · Published: October 1, 2009

Simple Explanation

This study investigates how age affects mortality, motor and sensory recovery, and functional recovery after traumatic spinal cord injury (SCI). It uses data from a large group of patients enrolled in the Third National Spinal Cord Injury Study (NASCIS 3). The study found that older individuals with SCI have a significantly higher mortality rate compared to younger individuals. However, among those who survived, age didn't significantly affect motor recovery or changes in pain scores. Despite similar sensorimotor recovery rates, older individuals experienced greater functional deficits than younger individuals. This suggests that rehabilitation programs tailored for older patients focusing on functional recovery might improve outcomes.

Study Duration

1 year

Participants

499 patients enrolled in the NASCIS-3 trial

Evidence Level

Level 2; Cohort Study

Key Findings

1
Older individuals (≥65 years) had significantly higher mortality rates at 6 weeks, 6 months, and 1 year following SCI compared to younger individuals.
2
Age was not significantly correlated with motor recovery or changes in pain scores in the acute and chronic stages after SCI among survivors.
3
Older individuals experienced greater functional deficits (based on FIM scores) than younger individuals, despite similar rates of sensorimotor recovery.

Research Summary

This study examined the impact of age on mortality, impairment, and disability after traumatic SCI using the NASCIS-3 database. The results indicated that older individuals had a significantly higher mortality rate during the first year following traumatic SCI compared to younger patients. Among survivors, neurological improvement in older patients did not translate into similar functional recovery compared to younger individuals, suggesting a need for rehabilitation protocols focused on functional recovery for older patients.

Practical Implications

Targeted Rehabilitation

Rehabilitation programs should be tailored to address the specific needs and challenges of older adults with SCI, with a focus on improving functional outcomes.

Mortality Risk Awareness

Healthcare providers should be aware of the increased mortality risk among older adults with SCI and implement strategies to mitigate this risk.

Realistic Expectations

Clinicians and patients should have realistic expectations regarding functional recovery after SCI, recognizing that age may impact the extent of recovery.

Study Limitations

1
Lack of detailed data on pre-existing medical co-morbidities.
2
Potential effects of ageism on the outcomes in acute SCI care and rehabilitation care.
3
A significant ceiling effect was found for FIM in the assessment of spinal cord–injured individuals.

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