In 2016 the age distribution of elderly people (age over 65 years) to children (age 0-15 years) was equally split. However, by 2026 it is projected that people aged 65 and over will outnumber children for the first time in history.

SIA Case Management spoke to Alison Conway, Partnership Liaison Manager and Registered General Nurse, having worked with many people following a life changing Spinal Cord Injury (SCI), to find out more about the impact of an ageing population and SCI.

The number of people living with an SCI in the UK currently is estimated to be 40.000 with 1,000 people becoming newly injured each year. The percentage of older persons within the overall SCI population has increased from 4.2% in the early 1980s to 15.4% of admissions in the first half of the current decade.

75 years of age was different from those in younger age groups. 74% of older people sustained an SCI as a result of a fall, with road traffic collisions being the second highest reason (13%). There are also a significant number of cases where complications of a medical condition can result in a spinal cord injury, e.g. ankylosing spondylitis, aneurysm or spinal stroke.

In a survey reported by the Spinal Injuries Association (SIA) in 2008, 32% of respondents were over 60 years of age. This survey also demonstrated that there was also a strong correlation between age and number of complications on admission to, and during, a hospital stay.

Ageing with an SCI, or a new SCI in older age groups, brings its own unique problems and additional risks.

A number of studies have shown a greater number of co-morbidities and higher mortality in older individuals who sustained a SCI.

One study (31) suggested that ageist attitudes are more prevalent in the acute hospital setting versus the rehabilitation setting and that this can impact on perception of quality of life, which in turn impacts on the care that the older person receives .

The ‘normal’ ageing process and the higher incidence of concomitant disease means older people with a SCI require specialist knowledge, therapy services, care and rehabilitation to reduce their risk of complications and maximise their rehabilitation potential.

Figure 1 below outlines common problems and conditions associated with ageing and highlights their impact on individuals with an SCI.

Figure 1

Recently and on a positive note, a number of studies have found that age in itself does not affect rehabilitation outcomes or the potential for neurological recovery.

However, it is crucial that rehabilitation is carefully planned and coordinated, with appropriate and timely access to specially trained therapists who can recognise and respond to the needs of the older patient with an SCI.

A case manager with specialist skills in SCI will not only be able to recognise the needs and challenges of the individual with a SCI but can manage this in the context of the additional issues ageing adds to the overall picture.

To speak to a member of the SIA Case Management team about SCI and how the service can help email enquiry@siacasemanagement.co.uk or telephone 01327 223821.

Every referral made to SIA Case Management provides a charitable donation, at no additional cost to you, to the Spinal Injuries Association to help provide support services for anyone following SCI.

Sources:
Office for National Statistics, 2017) – www.ons.gov.uk/peoplepopulationandcommunity
Spinal Injuries Association. Survey on Ageing with a Spinal Cord Injury. 2008
Fehlings MG, Furlan JC. Effect of age on spinal cord injury. J Neurosurg Spine 2007; 7(3):275-276.
Furlan JC, Kattail D, Fehlings MG. The impact of co-morbidities on age-related differences in mortality after acute traumatic spinal cord injury. J Neurotrauma 2009; 26(8):1361-1367.
McGlinchey-Berroth R, Morrow L, Ahlquist M, Sarkarati M, Minaker KL. Late-life spinal cord injury and aging with a long term injury: characteristics of two emerging populations. J Spinal Cord Med 1995; 18(3):183-193.
Claxton AR, Wong DT, Chung F, Fehlings MG. Predictors of hospital mortality and mechanical ventilation in patients with cervical spinal cord injury. Can J Anaesth 1998; 45(2):144-149.
DeVivo MJ, Kartus PL, Rutt RD, Stover SL, Fine PR. The influence of age at time of spinal cord injury on rehabilitation outcome. Arch Neurol 1990; 47(6):687-691.
DeVivo MJ, Stover SL, Black KJ. Prognostic factors for 12-year survival after spinal cord injury. Arch Phys Med Rehabil 1992; 73(2):156-162.
Golob JF, Jr., Claridge JA, Yowler CJ, Como JJ, Peerless JR. Isolated cervical spine fractures in the elderly: a deadly injury. J Trauma 2008; 64(2):311-315
Furlan JC, Craven BC, Ritchie R, Coukos L, Fehlings MG. Attitudes towards the older patients with spinal cord injury among registered nurses: a cross-sectional observational study. Spinal Cord 2009; 47(9):674-680.
Cifu DX, Seel RT, Kreutzer JS, McKinley WO. A multicenter investigation of age-related differences in lengths of stay, hospitalization charges, and outcomes for a matched tetraplegia sample. Arch Phys Med Rehabil 1999; 80(7):733-740.
Seel RT, Huang ME, Cifu DX, Kolakowsky-Hayner SA, McKinley WO. Age-related differences in length of stays, hospitalization costs, and outcomes for an injury-matched sample of adults with paraplegia. J Spinal Cord Med 2001; 24(4):241-250.