Abstract
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, 32y; range, 6–88y) 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.
Keywords
List of abbreviations:
SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 14, 2014
Footnotes
Supported by the National Institute of Disability and Rehabilitation Research of the U.S. Department of Education (grant nos. H133N110011 and H133B080024), National Center for Medical Rehabilitation Research (grant no. T32 HD049307), and the National Institute of Mental Health (grant nos. P30 MH090333 and T32 MH019986).
The content of the article does not necessarily represent the policy of the Department of Education or the National Institutes of Health, and readers should not assume endorsement by the federal government.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
