Aging Changes Spinal Cord Injury Recovery in a Surprising Way

A study published today (December 23, 2025) in Neurology, the medical journal of the American Academy of Neurology, explored how a person’s age may influence recovery after a spinal cord injury.

“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.”

Nerve Recovery Remains Strong Across Ages

The researchers found that age did not appear to affect neurological recovery. Older and younger participants showed similar improvements in motor function and sensation, including strength in the arms and legs and the ability to feel light touch or pinprick sensations.

These findings suggest that the nervous system’s ability to recover after spinal cord injury may remain relatively stable regardless of age.

Daily Independence Declines With Age

While nerve recovery was consistent, the study showed a different pattern when it came to everyday functioning. Older participants experienced poorer recovery in practical abilities such as feeding themselves, bathing, managing bladder and bowel function, and moving independently.

Older adults also performed worse on walking tests, including measures of how quickly someone could walk a short distance, either on their own or with help such as a cane.

One-Year Follow-Up of Over 2,000 Patients

The study followed 2,171 people with spinal cord injuries, whose average age was 47. All participants were treated at spinal care units that are part of the European Multicenter Study about Spinal Cord Injury.

Researchers tracked participants for one year after their injuries and repeatedly tested their physical and functional abilities. They then analyzed how age related to the amount of recovery achieved during that year.

Measurable Declines in Functional Scores

Although age had no link to neurological outcomes, it was strongly associated with functional recovery. Independence was measured using a scale ranging from zero to 100, with higher scores reflecting better ability to manage daily life activities.

At admission to a spinal care unit, participants scored an average of 31 points. After one year, the average score rose to 35. However, each additional decade of age was linked to a 4.3-point reduction in recovery on this scale. Older participants showed less improvement on every walking-related test compared with younger individuals.

These results were consistent even after accounting for the type of spinal cord injury and how severe it was.

Recovery Drops Sharply After Age 70

The researchers identified a notable decline in functional recovery among people older than 70, suggesting that advanced age presents additional challenges during rehabilitation.

“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.

Study Limitations

The researchers noted an important limitation. Many people included in the original database were no longer part of the study after one year, and limited information was available about why they dropped out or whether they died during that time.

Because those who left the study may have differed from those who remained, this loss of participants could have influenced the results.

Reference: 23 December 2025, Neurology.

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.

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