Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA.
Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
Arch Phys Med Rehabil. 2014 Jun;95(6):1076-82. doi: 10.1016/j.apmr.2014.01.022. Epub 2014 Feb 12.
To examine the additive effect of age on disability for adults with spinal cord injury (SCI).
Prospective cohort study.
SCI Model Systems.
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.
Not applicable.
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.
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.
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.
探讨年龄对脊髓损伤（SCI）成年人残疾的附加影响。
前瞻性队列研究。
SCI 模型系统。
具有 SCI（损伤时的中位年龄为 32 岁；范围为 6-88 岁）出院时的运动 FIM 评分和至少 1 次随访运动 FIM 评分，并且提供其他协变量测量值的个体（N=1660）。在总样本中，79%为男性，72%为白人，16%为不完全性截瘫，33%为完全性截瘫，30%为不完全性四肢瘫，21%为完全性四肢瘫。
不适用。
主要研究结果是 FIM 的运动子量表。使用混合模型方法来检查年龄对 SCI 患者残疾的附加影响。
在控制康复出院时的运动 FIM、损伤水平和严重程度、损伤时的年龄、性别、种族以及年龄×时间交互作用后，年龄对残疾的影响不显著（P=.07）。SCI 时的年龄与运动 FIM 显著相关（F1,238=22.49，P<.001）。两项敏感性分析发现，年龄×时间（P=.03，P=.02）和年龄×时间平方（P=.01，P=.006）模型的交互作用均有显著意义。运动 FIM 评分的轨迹受损伤时年龄的轻微调节。损伤时年龄越大，发现曲率越大，后期下降越快。
这些发现表明年龄对某些 SCI 患者的残疾有一定影响：损伤时年龄越大，年龄对残疾的影响越大。这些发现为评估和制定旨在增强 SCI 患者加速衰老的干预措施提供了重要的实证基础。
