title: Additive effect of age on disability for individuals with spinal cord injuries.
abstract: OBJECTIVE
  To examine the additive effect of age on disability for adults with spinal cord injury (SCI).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  SCI Model Systems.
  
  
  METHODS
  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.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.
authors: Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA. Electronic address: Jur17@pitt.edu.
authors: Juleen
authors: J
authors: Rodakowski
authors: Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
authors: Elizabeth R
authors: ER
authors: Skidmore
authors: Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA.
authors: Stewart J
authors: SJ
authors: Anderson
authors: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA.
authors: Amy
authors: A
authors: Begley
authors: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors: Mark P
authors: MP
authors: Jensen
authors: Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA.
authors: Olive D
authors: OD
authors: Buhule
authors: Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
authors: Michael L
authors: ML
authors: Boninger
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000534:rehabilitation; D011446:Prospective Studies; D011782:Quadriplegia / Q000534:rehabilitation; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Aging; Rehabilitation; Spinal cord injuries