The age-dependent deterioration in light touch sensation on the plantar aspect of the foot in a rural community in India: implications when screening for sensory impairment

Abstract

Summary Regular testing for impaired sensation is important in the management of diseases that can cause progressive nerve damage, such as leprosy. It has been shown that light touch sensibility decreases with age in the hands of healthy individuals, but little research has been undertaken to assess possible changes in the feet in developing countries. This information is needed to allow an appropriate level of sensation to be chosen when screening for nerve damage in the foot. To clarify this, a cross-sectional study on male adults was carried out in the rural town of Salur, Andhra Pradesh, India. A range of Semmes-Weinstein monofilaments were employed at 12 locations on the foot to determine sensation to light touch stimuli in individuals from each decade of adult life. It was found that in this population, sensibility threshold in the foot increases with age and this was noted in both soft and callous skin. This shows the increase was due to neurological factors, not merely due to an increase in callous deposition with advancing age. In the majority of individuals in their fifties and sixties, the callous skin at the forefoot and heel was unable to detect the 5.07 monofilament (equivalent to 8-12 g), previously recommended as a method to screen for plantar neuropathy. All areas of all feet were able to detect the 5.46 filament (approximately 30 g). The size of this study (54 individuals) prevents the determina tion of definitive normal ranges for each decade of life in this population. However, it does demonstrate the degree to which sensation deteriorates with age and could be used as an approximate guide when interpreting the results of sensory testing in similar rural areas of the developing world.The feet of leprosy patients are prone to sensory impairment following lesions of peripheral nerves. Often neuropathy persists after microbiological cure and the challenge of prevention of complications can remain throughout life. Complications in the foot include resorption of

Decline of tactile acuity in aging: a study of body site, blood flow, and lifetime habits of smoking and physical activity

“…The effect of age on tactile spatial acuity was nearly identical on both surfaces of the finger and foot. This result agrees with a recent study conducted on rural subjects in India that showed that the effect of age on tactile sensitivity, as measured by von Frey filaments, was approximately the same at multiple sites on the top and bottom of the foot (Mitchell and Mitchell, 2000).…”

Lower touch sensibility in the extremities of healthy Indians: further deterioration with age

“…This increase is evident in both sexes and across the age of 10–80 years. Touch threshold values in our study are closer to reports from Asia where only a partial set of SWM filaments were used ( Malaviya et al, 1994; Kets et al, 1996; Birke et al, 2000; Mitchell and Mitchell, 2000 ) .…”

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

“…The greater morphological changes and reduced numbers of Meissner's corpuscles seen in the hands of older manual workers and to a lesser extent, older males in general (Cauna 1956(Cauna , 1965, suggest that increased damage may occur to neuromuscular structures in high contact areas (Cauna 1965). Previous studies found no difference between sensory declines on the dorsal and ventral sides of the finger (Stevens et al 2003) and foot (Mitchell and Mitchell 2000) with age, and suggested increases in skin thickness (Mitchell and Mitchell 2000) and skin wear (Stevens et al 2003) did not contribute to sensory decline. However, in these studies, the skin of the palm was not investigated.…”