Traumatic spinal cord injuries are on the rise in the United States, and while until recently the chief cause was car crashes, new research from the Johns Hopkins School of Medicine finds that more recently falls are more likely to cause the injuries. In addition, the rate of spinal cord injuries, which can range in severity from temporary numbness to permanent paralysis, is highest among older adults.

“We have demonstrated how costly traumatic spinal cord injury is and how lethal and disabling it can be among older people,” says Shalini Selvarajah, M.D., M.P.H., a postdoctoral surgical research fellow at the Johns Hopkins University School of Medicine and an author of the new study. “It’s an area that is ripe for prevention,” Selvarajah says.

The researchers looked at data on over 45,0000 adults treated in hospital emergency rooms for spinal cord injury in the United States between 2007 and 2009. The injury incidence among people age 18 to 64 ranged from 52.3 per million in 2007 to 49.9 per million in 2009,  and among people 65 and older, the incidence was 79.4 per million in 2007 to 87.7 per million. The researchers found that fall-related spinal cord injuries increased during the study period overall, and among the elderly, they increased from 23.6 percent to 30 percent of injuries.

A previous study for the years 2000 to 2005 put the average age of someone with a spinal cord injury at 41. The new Johns Hopkins study suggests the average age may now be 51. Spinal cord injuries are more likely to lead to death for older victims than younger ones. The researchers say that even taking severity of injury and other illnesses an older person may have into account, older adults with traumatic spinal cord injury are four times more likely to die in the emergency room from such an injury compared to younger adults. If they survive and are admitted, they are six times more likely to die during their hospital stay.

The researchers say falls may have surpassed car crashes as a cause of spinal injuries for several reasons including:

• The general aging of the population,
• The more active lifestyles of many Americans over 65,
• Airbags and seatbelt laws that allow drivers and passengers to survive crashes.

“We are seeing a changing face in the epidemiology of spinal cord injury,” says Edward R. Hammond, M.D., Ph.D., a research associate at the International Center for Spinal Cord Injury at the Kennedy Krieger Institute at Johns Hopkins and an author of the study.

The spinal cord injuries are also increasing health care costs, according to the study. From 2007 to 2009, emergency room charges for traumatic spinal cord injury patients totaled $1.6 billion and increased by 20 percent of the study period.

The researchers say the National Institutes of Health is looking to fund improved efforts to prevent falls that lead to traumatic brain injury in the elderly, and that effort could also reduce falls that lead to traumatic spinal cord injuries.

The study was published in the Journal of Neurotrauma.