Aging Population and Traumatic Spinal Cord Injury, pp. 427-446
Authors: Julio C. Furlan
Abstract: The aging of the general population has led to substantial changes in the demographics of people with neurotrauma in western society. The proportion of traumatic spinal cord injury (SCI) among older people is rising. Although motor vehicle accident is the leading cause of traumatic SCI among young individuals, there has been a worldwide escalation in fall-related SCI among the elderly over the last 20 years. However, relatively little has been reported to date regarding clinical and neurological outcomes in the elderly after traumatic SCI. Physiologic changes related to aging have been accepted as a major reason for increased susceptibility to, and slow recovery and residual debilitation from, an acute injury. In recent studies based on large cohorts of patients with SCI, mortality rates among the geriatric group were consistently reported as significantly greater than non-geriatric group during acute and chronic stages posttrauma. Nonetheless, the impact of age on impairment and disability among the survivors of traumatic SCI remains a matter of debate. The review of previous investigations on the influence of age in neurological outcome after SCI suggests that heterogeneity in results may depending on methodology. Matching techniques or adjusted data analyses should be applied for controlling potential major confounders. Despite the lack of understanding of the role of age in the potentials for recovery after SCI, the clinician needs to guard against succumbing to “ageism” which refers to biased, negative, stereotyped misperceptions about the elderly and their performance in society.