Age-related changes in cutaneous sensation in the healthy human hand

Abstract

Cutaneous sensation deteriorates with age. It is not known if this change is consistent over the entire hand or if sensation is affected by changes in skin mechanics. Cutaneous perceptual thresholds were tested at eight sites in the glabrous skin and two in the hairy skin of both hands in 70 subjects (20-88 years), five male and five female per decade, using calibrated von Frey filaments, two-point discrimination, and texture discrimination. Venous occlusion at the wrist (40±10 mmHg) and moisturizer were used to alter skin mechanics. Cutaneous thresholds increased significantly with age (p<0.001); von Frey thresholds were 0.04 g [0.02-0.07] (median and interquartile range) in the 20s and 0.16 g [0.04-0.4] in the 80s, with differences between hands for older females (p00.044) but not males. The pattern of changes in cutaneous sensation varied according to the site tested with smaller changes on the fingers compared to the palm. Two-point discrimination deteriorated with age (p00.046), but with no interaction between sex, handedness, or changes in skin mechanics. There were no significant differences for texture discrimination. Changes in skin mechanics improved cutaneous thresholds in the oldest males after moisturizing (p00.001) but not otherwise. These results emphasize the complex pattern of age-related deterioration in cutaneous sensation with differences between sexes, the hands, sites on the hand, and the mode of testing. As the index fingertip is not a sensitive indicator of sensory decline, the minimum assessment of age-related changes in cutaneous sensation should include both hands, and sites on the palm.

Relationship Between Laterality and Handedness With the Higher Order Sensory Functions and Manual Dexterity of the Elderly

“…Studies have shown that cutaneous sensation changes in the dominant and non-dominant hands of the elderly and in different areas of the hand through a complicated pattern; thus, limited changes are observed in some areas (such as the tip of the index finger) and extensive changes occur in other areas (such as the hypothenar area) [2]. The lack of significant differences in the functions of the dominant and non-dominant hand can thus be attributed to the fact that both HORT and HAST involve object manipulation and thus necessitate application of all hand areas.…”

“…Francis et al, have suggested that with increasing age the ability to perform difficult tasks using the non-dominant hand deteriorates more as compared with that of the dominant hand [4]. The difference in fine motor function between the dominant and non-dominant hand of right-handed elderly individuals results from the complexity and difficulty of the fine motor functions as compared with gross motor function [2,4].…”

“…This, in turn, restricts their active participation in social activities [1]. Previous studies have showed that hand functions, such as coordination, dexterity, muscle power and sensory ability, gradually deteriorate with aging [1,2]. It was thus proposed that detailed analysis of hand sensory-motor assessments can play crucial roles in geriatric rehabilitation and public health preservation.…”

The Significance of Somatosensory Stimulation to the Hand: Implications for Occupational Therapy Practice

“…In fact, dexterous manual work leads to the acquisition of tactile expertise, and this expertise may delay the age effects on the decline in tactile perception (Höffken et al, 2007). In a study on the age-related changes in the human hand, Bowden and McNulty (2013) found that the hypothenar eminence is a better site than the index finger for testing agerelated discrimination loss. Curiously, they also found that skin moisturizers used on the hands helped participants to better discriminate among different sensory stimuli.…”

Estimating the influence of age-related changes in skin stiffness on tactile perception for static stimulations

“…Moreover, it is known that tactile perceptions change with aging and that elderly people have dull perceptions (Stevens, 1992;Carmeli et al, 2003). However, how age-related changes in skin stiffness affect tactile perceptions have not been elucidated with experiments (Wickremaratchi and Llewelyn, 2006;Bowden and McNulty, 2013) because of the associated difficulty. For example, using subjective experiments, many parameters such as the mechanical properties, the transmittance of nerve signals, and individual feelings are intricately mixed; therefore, it is difficult to identify the effects of individual elements and the extent of their effects.…”