A new study reveals that while nerve function recovers similarly across age groups following spinal cord injuries, older adults face greater challenges in regaining everyday independence. Published in Neurology on December 23, 2025, the research highlights the need for age-tailored rehabilitation approaches. Led by Chiara Pavese of the University of Pavia, the findings draw from over 2,000 patients in Europe.
Spinal cord injuries are increasingly affecting older adults due to population growth and medical advances, yet recovery patterns show a surprising divide by age. The study, involving 2,171 participants with an average age of 47 from the European Multicenter Study about Spinal Cord Injury, tracked neurological and functional outcomes over one year.
Neurological recovery proved resilient to age. Older patients regained motor strength in arms and legs, as well as sensory functions like light touch and pinprick sensation, at rates comparable to younger individuals. This suggests the body's nerve healing mechanisms remain effective regardless of age.
In contrast, functional recovery declined with advancing years. Participants' independence in daily activities—such as feeding, bathing, bladder and bowel management, and mobility—was assessed on a 0-100 scale, starting at an average of 31 upon admission and rising to 35 after one year. Each additional decade of age correlated with a 4.3-point smaller improvement. Walking tests, measuring speed over short distances with or without aids like canes, also showed less progress among older adults.
The differences persisted even after adjusting for injury type and severity. A sharper decline emerged after age 70, where comorbidities like cardiovascular disease, diabetes, or osteoporosis likely play a role. "People older than 70 need specific approaches to rehabilitation that take into account other conditions they may be living with, and help them with recovery that applies to their daily lives," Pavese noted.
Despite stagnant overall recovery rates despite medical progress, these insights could guide age-specific therapies. Limitations include high dropout rates after one year, with unclear reasons such as death potentially biasing results. The research was funded by organizations including the Swiss National Science Foundation and the European Union's Horizon 2020 program.
