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Although experience suggests a shift in the epidemiology of spinal cord injury (SCI) toward an older demographic, population studies are lacking. We aimed to evaluate 1) how the epidemiology and age profile of SCI have changed over time, and; 2) how increased age impacts health outcomes up to 15 years post injury. A population-based cohort study was performed in Ontario including adults diagnosed with traumatic SCI between 2002-2017. Older and younger SCI cohorts were created based on an age cut-off of 65 years. An older cohort of non-