Additive effect of age on disability for individuals with spinal cord injuries.

TitleAdditive effect of age on disability for individuals with spinal cord injuries.
Publication TypeJournal Article
2014
AuthorsRodakowski J, Skidmore ER, Anderson SJ, Begley A, Jensen MP, Buhule OD, Boninger ML
JournalArch Phys Med Rehabil
Volume95
Issue6
Pagination1076-82
Date Published2014 Jun
ISSN1532-821X
Activities of Daily Living, Adult, Age Factors, Age of Onset, Aged, Aged, 80 and over, Cohort Studies, Disability Evaluation, Disabled Persons, Female, Follow-Up Studies, Humans, Injury Severity Score, Length of Stay, Male, Middle Aged, Paraplegia, Prospective Studies, Quadriplegia, Risk Assessment, Spinal Cord Injuries, Time Factors, Treatment Outcome, Young Adult

OBJECTIVE: To examine the additive effect of age on disability for adults with spinal cord injury (SCI). DESIGN: Prospective cohort study. SETTING: SCI Model Systems. PARTICIPANTS: Individuals with SCI (median age at injury, 32 y; range, 6-88 y) with a discharge motor FIM score and at least 1 follow-up motor FIM score who also provided measures of other covariates (N=1660). Of the total sample, 79% were men, 72% were white, 16% had incomplete paraplegia, 33% had complete paraplegia, 30% had incomplete tetraplegia, and 21% had complete tetraplegia. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary study outcome was the motor subscale of the FIM. A mixed-models approach was used to examine the additive effect of age on disability for individuals with SCI. RESULTS: When controlling for motor FIM at discharge from rehabilitation, level and severity of injury, age at injury, sex, race, and the age × time interaction were not significant (P=.07). Age at the time of SCI was significantly associated with motor FIM (F1,238=22.49, P<.001). Two sensitivity analyses found significant interactions for both age × time (P=.03, P=.02) and age × time-square (P=.01, P=.006) models. Trajectory of motor FIM scores is moderated slightly by age at the time of injury. The older participants were at the time of injury, the greater the curvature and the more rapid decline were found in later years. CONCLUSIONS: These findings indicate that age moderately influences disability for some individuals with SCI: the older the age at the time of injury, the greater the influence age has on disability. The findings serve as an important empirical foundation for the evaluation and development of interventions designed to augment accelerated aging experienced by individuals with SCI.

10.1016/j.apmr.2014.01.022
PubMed ID24530841