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World Journal of Urology

, Volume 36, Issue 10, pp 1603–1611 | Cite as

Special considerations in the urological management of the older spinal cord injury patient

  • Lewis W. Chan
  • Tomas L. Griebling
  • Edwin P. Arnold
  • Peggy S. Chu
  • Peter W. New
  • Adrian Wagg
Topic Paper

Abstract

Purpose

This paper reports the key findings of Committee 8 of the Joint SIU–ICUD Consultation on Urologic Management of the Spinal Cord Injured Patient and address issues pertaining to the older person with a SCI and the time-related changes relevant to their urological, gastrointestinal and functional management.

Methods

A literature review using the Pubmed and Ovid search engines was performed examining pertinent literature regarding SCI in the older patient.

Results

There is a rising incidence of both traumatic and non-traumatic spinal cord injury (SCI) in older people and improvements in healthcare and nutrition mean patients with SCI are living longer. Outcomes after a SCI in the older person are a sum of the effects of injury and its management compounded by specific effects of ageing and the emergence of unrelated comorbidities. Changes in health, comorbidities, cognition and dexterity with ageing have an impact on function and are important considerations in the management of the older patient with SCI. Treatment decisions are thus increasingly complex due to the need to take into account these changes and accompanying polypharmacy. For the person living with a SCI, changes in circumstances (social and financial) have an impact on quality of life and influence management and support strategies.

Conclusions

Older patients with SCI face additional challenges both in the acute setting and with ageing. Clinicians should take into account comorbid conditions, mental health, physical function, cognition and social support in making management decisions. With the global ageing population, health services planning will need to allow for increase in resources required to care for older patients with SCI.

Keywords

Spinal cord injury Geriatric Older adult Ageing Elderly 

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Lewis W. Chan
    • 1
  • Tomas L. Griebling
    • 2
  • Edwin P. Arnold
    • 3
  • Peggy S. Chu
    • 4
  • Peter W. New
    • 5
    • 6
  • Adrian Wagg
    • 7
  1. 1.Department of Urology, Concord Repatriation General HospitalUniversity of SydneySydneyAustralia
  2. 2.Department of Urology and The Landon Center on AgingThe University of Kansas School of MedicineKansas CityUSA
  3. 3.Department of SurgeryOtago UniversityChristchurchNew Zealand
  4. 4.Division of Urology, Department of SurgeryTuen Mun HospitalHong Kong Special Administrative RegionChina
  5. 5.Alfred Health and Epworth-Monash Rehabilitation Medicine Unit, Caulfield Hospital, Spinal Rehabilitation ServiceMonash UniversityMelbourneAustralia
  6. 6.Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive MedicineMonash UniversityMelbourneAustralia
  7. 7.Department of MedicineUniversity of AlbertaEdmontonCanada

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