Independent effects of peripheral nerve dysfunction on lower-extremity physical function in old age: the Women's Health and Aging Study.

Resnick, Helaine E.; Vinik, Aaron I.; Schwartz, Ann V.; Leveille, Suzanne G.; Brancati, Frederick L.; Balfour, Jennifer L.; Guralnik, Jack M.

doi:10.2337/diacare.23.11.1642

Cited by 129 publications

(125 citation statements)

References 28 publications

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“…Richardson and Hurvitz (28) identified peripheral neuropathy, measured as nerve conduction velocity, as a risk factor for falls. Studies in older adults with and without diabetes have found that peripheral neuropathy is associated with reduced balance and walking speed (29). We found that loss of pressure sensitivity was independently associated with falling.…”

Section: Multivariable Adjustmentmentioning

confidence: 48%

Older Women With Diabetes Have a Higher Risk of Falls

et al. 2002

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OBJECTIVE -To determine whether older women with diabetes have an increased risk of falls and whether known risk factors for falls account for any increased risk. RESEARCH DESIGN AND METHODS-This prospective cohort study included 9,249 women Ն67 years of age enrolled in the Study of Osteoporotic Fractures. Diabetes was determined by questionnaire at baseline. Physical performance was measured at the second examination. Subsequently, falls were ascertained every 4 months by postcard.RESULTS -A total of 629 (6.8%) women had diabetes, including 99 who used insulin. During an average of 7.2 years, 1,640 women (18%) fell more than once a year. Diabetes, stratified by insulin use, was associated with an increased risk of falling more than once a year (age-adjusted odds ratio [OR] 1.68 [95% CI 1.37-2.07] for non-insulin-treated diabetes; ageadjusted OR 2.78 [1.82-4.24] for insulin-treated diabetes). In the first 2 years of follow-up, women with diabetes were not more likely to fall than women without diabetes (44 vs. 42%; P ϭ 0.26), but they had more falls (3.1 vs. 2.4; P Ͻ 0.01). Women with diabetes were more likely to have other risk factors for falls, which appeared to account for the increased risk of falls associated with non-insulin-treated diabetes (adjusted OR 1.18 [0.87-1.60]) but not insulin-treated diabetes (adjusted OR 2.76 [1.52-5.01]).CONCLUSIONS -Older women with diabetes have an increased risk of falling, partly because of the increased rates of known fall risk factors, and may benefit from interventions to prevent falls. Further research is needed to determine whether diabetes treatment reduces fall risk.

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Section: Multivariable Adjustmentmentioning

confidence: 48%

Older Women With Diabetes Have a Higher Risk of Falls

et al. 2002

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“…Diabetic somatic peripheral neuropathy (DPN) is a chronic and potentially disabling complication of diabetes, having a negative impact on physical and psychosocial functioning and on the quality of life of persons affected by this disorder [1][2][3][4]. DPN is not a single entity but encompasses a variety of clinical manifestations that can include unremitting pain, reduced feeling in the feet and postural instability.…”

Section: Introductionmentioning

confidence: 99%

Predictors of depressive symptoms in persons with diabetic peripheral neuropathy: a longitudinal study

et al. 2009

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Aims/hypothesis The aim of the study was to determine whether diabetic peripheral neuropathy (DPN) is a risk factor for depressive symptoms and examine the potential mechanisms for this relationship. Methods This longitudinal study (9 and 18 month followup) of 338 DPN patients (mean age 61 years; 71% male; 73% type 2 diabetes) examined the temporal relationships between DPN severity (mean±SD; neuropathy disability score [NDS], 7.4±2.2; mean vibration perception threshold, 41.5±9.5 V), DPN somatic experiences (symptoms and foot ulceration), DPN psychosocial consequences (restrictions in activities of daily living [ADL] and social selfperception) and the Hospital Anxiety and Depression subscale measuring depressive symptoms (HADS-D; mean 4.9±3.7).Results Controlling for baseline HADS-D and demographic/disease variables, NDS at baseline significantly predicted increased HADS-D over 18 months. This association was mediated by baseline unsteadiness, which was significantly associated with increased HADS-D. Baseline ADL restrictions significantly predicted increased HADS-D and partly mediated the association between baseline unsteadiness and change in HADS-D. Increased pain, unsteadiness and ADL restrictions from baseline to 9 months each significantly predicted increased HADS-D over 18 months. Change in social self-perception from baseline to 9 months significantly predicted increased HADS-D and partly mediated the relationships of change in unsteadiness and ADL restrictions with change in HADS-D. Conclusions/interpretation These results confirm that neuropathy is a risk factor for depressive symptoms because it

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“…Interest in measuring vibrotactile sensitivity using objective methods is growing due to a proposed association with functional mobility in older adults [31] and also in connection with clinical studies testing the effectiveness of interventions aimed at improving peripheral nerve function especially in diabetic patients [36]. Accordingly, commercial devices have been developed that assess vibration sensitivity through psychophysical techniques aimed at identifying the minimum amplitude of vibratory stimulus required for perception (VPT).…”

Section: Introductionmentioning

confidence: 99%

Physiological correlates of age-related decline in vibrotactile sensitivity

Deshpande

Metter

Ling

et al. 2008

Neurobiology of Aging

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The purpose of this study was to describe age-related changes in vibrotactile sensitivity in participants of the Baltimore Longitudinal Study of Aging and to identify factors that are associated with impairment in vibrotactile sensitivity independent of age. Participants (n=523, age:26-95 years) underwent measurements of vibration perception threshold (VPT, 100Hz) under the 2 nd metatarsal head, glucose tolerance, serum inflammatory markers, nerve conduction parameters, movement time and cognition. Univariate and multivariate regression analyses were performed to identify factors that predicted VPT independent of age. Structural equation modeling was used to describe relationships between these variables. VPT was progressively higher with older age. Adjusting for age and height, VPT was similar in men and women and the slope of age-related decline was similar in the two genders. Age, height, peroneal nerve conduction velocity and peroneal nerve amplitude were independent predictors of VPT. Structural equation model demonstrated a direct relationship between peripheral nerve function and VPT. Height and circulating inflammatory markers may

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Independent effects of peripheral nerve dysfunction on lower-extremity physical function in old age: the Women's Health and Aging Study.

Cited by 129 publications

References 28 publications

Older Women With Diabetes Have a Higher Risk of Falls

Older Women With Diabetes Have a Higher Risk of Falls

Predictors of depressive symptoms in persons with diabetic peripheral neuropathy: a longitudinal study

Physiological correlates of age-related decline in vibrotactile sensitivity

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