The effect of aging and duration of disability on long term health outcomes following spinal cord injury

Abstract

The purpose of the study was to discover the independent and combined effects of age and duration of injury on selected long term health outcomes of 83 spinal cord injured (SCI) men (age range 21-79 years; duration of spinal cord injury 3-52 years) _ Specifically, the study examined a multivariate model which specified that age, duration, the interaction of age and duration, and level of lesion were related to the following health outcomes: pain, fatigue, functional independence, mobility, illness and symptomatology, perceived overall health, social support, life satisfaction, and economic stability. Age had significant main effects on three outcomes. With increasing age, the sample experienced more fatigue, decreased activity (due to pain), and more overall satisfaction with their lives. Duration of SCI showed significant main effects on two outcomes. As subjects lived longer with their SCI, they felt less financially secure and experienced more symptoms and illnesses. Significant interaction effects of age and duration of SCI were found for two outcomes. Older age combined with longer duration of SCI amplified subjects' perceptions of financial insecurity, and threats to health. The findings send a clear message to service-providers and policy makers about the added vulnerability of older disabled individuals, about the need for extra vigilance in health care issues, and about the necessity of a social-economic safety net for already disadvantaged individuals.

Clinical correlates of fatigue in spinal cord injury

“…This finding supports the descriptive reports found in the literature 1,7,[10][11][12][13] and confirms that fatigue is prevalent and of considerable concern in SCI. In persons already living with neurological impairment due to SCI, the additional impairment of fatigue could further limit activity and restrict participation in work, leisure and social activities.…”

“…6 Studies in Parkinson's and stroke have shown that fatigue can be distinguished from depression both in samples that have and have not controlled for depression. 1,6 Fatigue has been reported as an issue for people with spinal cord injury (SCI); [10][11][12][13] however, estimates on the prevalence of fatigue in this population and identification of the variables that explain the presence of fatigue severity are not clearly delineated in the literature. For example, some clinical variables such as chronic pain and sleep disturbance and various demographic factors such as sex, country of residence and age have been found to be associated with fatigue after SCI, 11,12,14,15 yet little is known about the independent contributions in explaining fatigue among these variables.…”

“…For example, Pentland et al 13 found that males with SCI reported increased fatigue with increasing age. However, a more recent study by McColl et al 11 found that fatigue was reported more in their younger sample (40-65 years) who also had a shorter duration of injury.…”

Quality of life, social participation, appraisals and coping post spinal cord injury: a review of four community samples

“…Assessment of an individual's satisfaction with their health, family relations, friendships, employment and finance, as well as sexual life and leisure time 31,32 is often used to assess subjective QOL. 33 Social role functioning and interactions with family and friends are likely to be of high significance to an individual; 34 therefore, measures of QOL cover content similar to the core aspects of social participation measures (ie role performance and social relationships) 1 Due to their relevance to social participation and handicap, subjective QOL measures can therefore also be considered when assessing community needs.…”

A 25-year longitudinal study of the natural course of aging after spinal cord injury

“…[8][9][10][11][12][13][14][15] In their 1990 study, DeVivo et al 11 examined the influence of age at SCI on rehabilitation outcomes. It was found that individuals who were at least 61 years old at the time of injury were more likely to have developed pneumonia, experience a gastrointestinal hemorrhage, develop pulmonary emboli and have renal stones prior to their first discharge than individuals who were 16-30 years at the time of injury.…”