How does age affect recovery from spinal cord injury?

EMBARGOED FOR RELEASE UNTIL 4:00 P.M. ET, TUESDAY, DECEMBER 23, 2025

MINNEAPOLIS — A new study published on December 23, 2025, in Neurology®, the medical journal of the American Academy of Neurology, looks at how age may affect recovery for people with spinal cord injuries.

“With population growth and improvements in medicine, the number of people diagnosed with spinal cord injury is increasing and the average age at the time of injury is rising,” said study author Chiara Pavese, MD, PhD, of the University of Pavia in Pavia, Italy. “Despite substantial advances in medicine and surgery over the past decades, the rate of recovery after spinal cord injury has remained the same. Our results may help researchers design studies tailored by people’s age to evaluate new therapies and approaches for people with spinal cord injury.”

Researchers found that older age does not appear to impact neurological recovery in areas such as motor and sensory abilities. But the study found that older people had worse recovery in functional areas such as ability to care for oneself with tasks such as feeding, bathing, bladder and bowel management and mobility. They also had worse recovery on tests of ability to walk, such as how fast a person can walk a short distance, with or without assistance such as a cane.

The study involved 2,171 people with an average age of 47, who were admitted to spinal units participating in the European Multicenter Study about Spinal Cord Injury. People were followed for one year after their injury. During that time, they were tested on their abilities. Researchers looked for relationships between age and how much they recovered their abilities over the year.

There was no relationship between age and neurological outcomes, including strength in the upper and lower body and the ability to sense a light touch or pin prick.

However, the researchers found that older people were more likely to have worse functional recovery than younger people. On a test of independence in daily life activities such as feeding, bathing, bladder and bowel management and mobility, overall scores ranged from zero to 100, with a higher score indicating better recovery. Scores for participants at the time they were admitted into the spinal care unit after injury averaged 31 points. After a year, scores averaged 35 points. Researchers found that every decade older was associated with a reduction of 4.3 points on the test. Older people had less improvement on all the tests of the ability to walk than younger people.

These results accounted for the type of spinal cord injury people had and how severe it was.

The researchers also found a noticeable reduction in functional recovery in people older than 70.

“People older than 70 need specific approaches to rehabilitation that take into account other conditions they may be living with, such as cardiovascular disease, diabetes or osteoporosis, and help them with recovery that applies to their daily lives,” Pavese said.

A limitation of the study was that a substantial number of people in the original database were no longer included after one year and limited information was available about reasons why they dropped out of the study or whether they died during that time. It’s possible that the people who dropped out of the study or died differed as a group from the people who remained in the study, which could affect the results.  

The study was supported by the Swiss National Science Foundation, Wings for Life Research Foundation, European Union’s Horizon 2020 research and innovation program, Swiss State Secretariat for Education, Research and Innovation and Italian Ministry of Health.

Discover more about spinal cord injury at Brain & Life®, from the American Academy of Neurology. This resource also offers a website, podcast, and books that connect patients, caregivers and anyone interested in brain health with the most trusted information, straight from the world’s leading experts in brain health. Follow Brain & Life® on Facebook, X, and Instagram.

The American Academy of Neurology is the leading voice in brain health. As the world’s largest association of neurologists and neuroscience professionals with more than 40,000 members, the AAN provides access to the latest news, science and research affecting neurology for patients, caregivers, physicians and professionals alike. The AAN’s mission is to enhance member career fulfillment and promote brain health for all. A neurologist is a doctor who specializes in the diagnosis, care and treatment of brain, spinal cord and nervous system diseases such as Alzheimer's disease, stroke, concussion, epilepsy, Parkinson's disease, multiple sclerosis, headache and migraine.

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