Functional changes in persons aging with spinal cord injury

Declines in general physical function and the effect of these changes on ac tivities of daily living and needs for assistance were assessed in 150 indi viduals with spinal cord injury (SCI). The sample consisted of outpatients returning for follow-up at the spinal cord injury clinic at Rancho Los Amig os National Rehabilitation Center in Downey, CA, The average duration of in jury of the sample was 13 years (range 1-37), and average age was 38 years (range 18-64), Twenty-four percent of those sampled experienced a decline o r change in their physical function within the last 5 years. Individuals ex periencing declines were significantly older than those without changes, av eraging 45 years versus 36 years. The group with change also had a longer d uration of injury, averaging 18 years versus 11 years compared to the group reporting no declines. Fatigue was the most frequently reported problem, f ollowed by pain and weakness. Over half of the group with changes required additional assistance with activities of daily living (ADLs). Family member s were the primary helpers for both ADLs and instrumental activities of dai ly living (IADLs) for those persons experiencing changes. The use of assist ive technology, primarily equipment for bathing, toileting, and low technol ogy devices, increased with time. The increased vulnerability to loss of fu nction in persons with advancing age and duration of injury in this populat ion with SCI suggests the need for early preventative measures, routine ass essments to detect changes, and access to health care and supportive servic es to alleviate or minimize the effect of these changes.