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Changes In Health-Related Quality of Life Among Older Adults Aging With Long-term Spinal Cord Injury

A spinal cord injury (SCI) may drastically alter a person’s life, typically related the limited mobility, functional impairment, and chronic pain caused by these injuries. Consequently, the main purpose of rehabilitation is to establish long-term management plans that will help these individuals reach and maintain their highest possible quality of life. The most common impairments that affect quality of life are motor and sensory deficits, as well as the compromise (or sometimes complete loss) of other physical functions. While many high-resource countries have advanced technology that enable these patients to live well into their elderly years, little research has attempted to measure or identify whether SCI patients’ quality of life changes as they age.

The Spinal Cord Injury Quality of Life questionnaire was developed to measure SCI-specific quality of life circumstances, gauging the physical, psychological, and social burdens associated with the injury. This questionnaire was used to survey 123 individuals aged 50 or older who sustained SCI at least 10 years prior, 77 of whom were re-interviewed six years later for follow-up. Their responses showed that:

  • Older individuals had a relatively high quality of life with no significant changes in this measure over six years. This may be because those with long-term disabilities are better prepared for age-related challenges, and their resilience and adaptability had strengthened over the course of their life.
  • The severity of injury had bearing on depressive feelings and quality of life. However, contrary to common belief, those with poorer physical and social health reported better mood and quality of life. Researchers attributed this to better access to rehabilitation programs that served as long-term support.
  • Those with less severe SCI showed worsening depression and quality of life over time, perhaps because relatively less “visible” disabilities, such as fatigue, are misunderstood or ignored by others.

While the study showed very promising results about SCI adults’ ability to maintain high quality of life with disability, it did highlight an overlooked area regarding less severe or less visible disabilities. Since their impairments seem modest in comparison, those with less severe SCI are excluded from long-term follow-up programs that could benefit them. Rehabilitation resources should be expanded to include all SCI patients, regardless of type of disability, to mitigate any negative changes over their lifetime.

Jörgensen S, Costa Andersson M, & Lexell J. Changes in health-related quality of life among older adults aging with long-term spinal cord injury. The International Spinal Cord Society. (November 2020).

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