Peripheral edema: A common and persistent health problem for older Americans

Abstract

Peripheral edema (i.e., lower limb swelling) can cause pain, weakness, and limited range of motion. However, few studies have examined its prevalence in the U.S. or its association with demographics, comorbidities, activity, or mobility. This study used data from the Health and Retirement Study, a nationally representative longitudinal survey of U.S. adults (age 51+/ N = 19,988 for 2016), to evaluate time trends and correlates of peripheral edema using weighted descriptive statistics and logistic regressions, respectively. Peripheral edema was assessed with the question “Have you had… // Persistent swelling in your feet or ankles?” The weighted prevalence of edema among older U.S. adults was 19% to 20% between 2000 and 2016. Peripheral edema was associated with older age, female sex, non-white race, low wealth, obesity, diabetes, hypertension, pain, low activity levels, and mobility limitations (odds ratios ranging from 1.2–5.6; p-values ≤0.001). This study provides the first estimates of national prevalence and correlates of peripheral edema among older Americans. Peripheral edema is common and strongly associated with comorbidities, pain, low activity levels, and mobility limitations, and disproportionately affects poorer and minority groups. Peripheral edema should be a focus of future research in order to develop novel and cost-effective interventions.

The effect of an 8-week treatment program using a novel foot neuromuscular electrical stimulator on physical function, leg pain, leg symptoms, and leg blood flow in community-dwelling older adults: a randomized sham-controlled trial

“…These symptoms are often associated with poor blood flow in the lower limbs and can arise due to prolonged inactivity, a sedentary lifestyle and/or be associated with undiagnosed peripheral artery disease [ 1 , 4 , 6 , 10 ]. A “vicious cycle” model describes the progressive nature of such symptoms; pain and discomfort limit physical activity, and these consequential limitations in activity further worsen lower leg symptoms [ 3 ].…”

“…However, these lower leg symptoms can develop due to prolonged inactivity, a sedentary lifestyle, and restricted movement/activity due to medical circumstances. Associations between pain, low levels of physical activity, and physical limitation have led to the development of a “vicious cycle” model in which leg symptoms limit physical activity; in turn limitation of activity levels increases the severity of leg symptoms [ 3 ]. Such symptoms can indicate poor blood flow to the legs [ 1 , 4 – 6 ].…”

The effect of an eight-week treatment program using a novel foot neuromuscular electrical stimulator (NMES) on physical function and leg pain, symptoms and blood flow in community dwelling older adults: a randomized sham-controlled trial

“…These symptoms are often associated with poor blood flow in the lower limbs and can arise due to prolonged inactivity, a sedentary lifestyle and/or be associated with undiagnosed peripheral artery disease (Gerhard-Herman 2017, McDermott 2017, BMJ Best Practice 2020, Criqui 2021. A 'vicious cycle' model describes the progressive nature of such symptoms; pain and discomfort limit physical activity, and these consequential limitations in activity further worsen lower leg symptoms (Besharat 2021).…”

“…Associations between pain, low levels of physical activity, and physical limitation have led to the development of a 'vicious cycle' model in which leg symptoms limit physical activity; in turn limitation of activity levels increases the severity of leg symptoms (Besharat 2021). Such symptoms can indicate poor blood flow to the legs (Gerhard-Herman 2017, McDermott 2017, BMJ Best Practice 2020, Criqui 2021.…”

Non-Specific Low Back Pain, Dietary Salt Intake, and Posterior Lumbar Subcutaneous Edema

“…Symptoms of edema include swelling, tightness, pain, and stiff joints [ 14 ], and cases with PLSE may be accompanied by these edema symptoms. Similar to pain and limited mobility with restricted range of motion associated with edema of peripheral limbs [ 15 ], LBP is associated with restricted lumbar range of motion and mobility impairment, sometimes in combination with lower extremity pain [ 16 ]. Additionally, qualitative studies of patients with LBP report symptoms of stiffness, which is consistent with tightness and stiff joints from edema [ 17 ], although the authors noted that “feeling stiff” is not a reliable biomarker of biomechanical impairment.…”