Functional aspects in ageing adults with diabetic neuropathy. A review.

Abstract

Diabetic Peripheral Neuropathy (DPN) is highly prevalent among diabetic ageing adults. The sensory and motor impairments caused by this long-term complication lead to poorer physical functioning, postural control and balance. These changes affect the activities of daily living and increase the risk of falling, subsequently leading to increased morbidity and decreased quality of life. Early detection of such functional limitations is important, as it may influence the effectiveness of rehabilitation programs and prevent further functional dependence. This review focuses on functional aspects related to balance, postural control and mobility in ageing adults suffering from DPN, as well as their assessment by valid, reliable and low-cost performance-based measurements. PUBMED was searched for articles in English published between 2004 and 2014. Search terms included diabetic neuropathy, balance, postural control, functional mobility, and functional outcomes. Reviewed literature indicates that simple and low-cost measurements, easy to include in clinical routines, can be used for screening impairments in complex functions, such as balance and mobility. Some studies have also been able to correlate results from DPN severity scales with those of functional tests, showing that applying such tests may improve the early diagnosis of this neurological disorder. Berg Balance Scale, Dynamic Gait Index, Functional Reach Test, and Time Up and Go already have modified cut-off points for the Diabetes Mellitus older population, but need validation for ageing adults with DPN. Further research on this subject should be addressed, in order to improve assessment outcomes.

Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life

“…In this context, diabetes mellitus is associated with an increased risk of falls due to diabetic complications such as sensory and motor diabetic neuropathy, retinopathy, or vestibular dysfunction [ 52 ]. Diabetic peripheral neuropathy may lead to foot ulcers, infections, and foot amputations, further aggravating the situation [ 53 , 54 , 55 ]. In fact, older people with type 2 DM have a greater risk of falling than healthy older individuals [ 56 , 57 ], and it is estimated that 25% of diabetic patients aged over 65 years have suffered falls compared to 18% among their non-diabetic peers [ 52 ].…”

Impact of neuropathy on the adherence to diabetes-related self-care activities: a cross-sectional study

“…For the best outcomes of rehabilitation programs and prevention of dependence, the early detection of these functional limitations is extremely important. 6 A frequent chronic complication of diabetes is represented by cardiac autonomic neuropathy, 7 which can have deadly outcomes through the impairment of autonomic nerve fibers responsible for heart rate, myocardial contractility, cardiac electrophysiology, blood vessel increase, or decrease in contractility. Arrhythmias, asymptomatic myocardial ischemia and infarction, intraoperative cardiovascular instability, and increased postinfarction mortality rate are reminded among the wide range of cardiac disorders present in cardiac autonomic neuropathy.…”