Individuals with more recent injuries tend to have higher levels of psychological stress than those many years post injury. Stress is likely not to be related to severity of injury nor presence of medical problems related to SCI. Good news is that stress levels do not appear to be higher than the general population and life satisfaction is generally rated as high. Depression seems to be lowest in those injured for the longest time.

Nearly one-half of persons with SCI require some personal assistance. Individuals with Paraplegia are most likely to need assistance with transfers and for Tetraplegia, mobility is the number one need. Sixty percent of individuals under age 60 are independent for all self care and 30% after age 75. Transfers, bathing and toileting are the most frequent activities of living (ADL's) affected by age and shopping, household chores and transportation the most frequent independent ADL's affected by age.

What Can Be Done Good health management over time can help address many of the problems associated with aging with SCI. This includes:

" Regular evaluations for blood lipids and glucose, blood pressure and thoughtful medication management.

" Appropriate activity levels, weight maintenance, smoking cessation, good dietary habits and alcohol limitation.

" Adequate hydration and hygienic bladder management.
" Screening for diabetes and insulin resistance.

" Particular attention to respiratory, cardiovascular and musculoskeletal health.

" Periodic evaluations to address posture, cushions, Pressure Release strategies, chair modifications or need for power assist, stress reduction, especially for wrists, elbows and shoulders.

" Maximize social and community involvement and activities that reduce stress, combat depression and maintain self-esteem

Readers interested in further information may wish to consult:

" Aging With Spinal Cord Injury by Gale. G. Whiteneck Ph.D. and others. (Book - 388 pages, 1993)