peripheral sensory neuropathy in older patients

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Abstract from J Am Board Fam Pract. 2004 Sep-Oct;17(5):309-18. Related

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The prevalence, predictors, and consequences of peripheral sensory

neuropathy in older patients.

Mold JW, Vesely SK, Keyl BA, Schenk JB, M.

Departments of Family and Preventive Medicine, University of Oklahoma

Health Sciences Center, Oklahoma City.

BACKGROUND:

The prevalence, predictors, and consequences of peripheral neuropathy in

the elderly have not been well defined.

METHODS: Seven hundred ninety-five noninstitutionalized patients 65

years of age and older, recruited from the practices of family

physicians, completed questionnaires and underwent peripheral neurologic

examinations and tests of gait and balance. Variables included

sociodemographic information, medical conditions, symptoms (numbness,

pain, trouble with balance or walking, and restless legs), quality of

life measures, ankle reflexes, position sense, vibratory sense, fine

touch sensation, Tinnetti balance examination, and a 50-foot timed walk.

RESULTS: The prevalence of at least one bilateral sensory deficit rose

from 26% for 65- to 74-year-olds to 54% for those 85 and older. The most

common deficit was loss of ankle reflex followed by loss of fine touch.

Only 40% of those with bilateral deficits reported having a disease

known to cause peripheral neuropathy. Predictors of bilateral deficits

included increasing age, income less than $15,000, a history of military

service, increasing body mass index, self-reported history of diabetes

mellitus, Vitamin B(12) deficiency or rheumatoid arthritis, and absence

of a history of hypertension. Deficits were associated with numbness,

pain, restless legs, trouble walking, trouble with balance, and reduced

quality of life.

CONCLUSIONS: Peripheral sensory deficits are common in the elderly. In

most cases, a medical cause is not obvious. Their consequences may not

be as benign as often supposed.