Peripheral neuropathy in young‐old and old‐old patients

Verghese, Joe; Bieri, Phyllis; Gellido, Charles; Schaumburg, Herbert H.; Herskovitz, Steven

doi:10.1002/mus.1171

Cited by 76 publications

(43 citation statements)

References 22 publications

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“…In referred populations, however, idiopathic peripheral neuropathy is more common with increasing age. For example, Verghese et al 39 found that 39% of those aged Ն80 but only 9% of those aged 65 to 79 were classified as idiopathic.…”

Section: Prevalence and Significancementioning

confidence: 99%

The Prevalence, Predictors, and Consequences of Peripheral Sensory Neuropathy in Older Patients

Mold

Vesely²,

Keyl³

et al. 2004

The Journal of the American Board of Family Medicine

211

135

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Background:The prevalence, predictors, and consequences of peripheral neuropathy in the elderly have not been well defined.Methods: Seven hundred ninety-five noninstitutionalized patients 65 years of age and older, recruited from the practices of family physicians, completed questionnaires and underwent peripheral neurologic examinations and tests of gait and balance. Variables included sociodemographic information, medical conditions, symptoms (numbness, pain, trouble with balance or walking, and restless legs), quality of life measures, ankle reflexes, position sense, vibratory sense, fine touch sensation, Tinnetti balance examination, and a 50-foot timed walk.Results: The prevalence of at least one bilateral sensory deficit rose from 26% for 65-to 74-yearolds to 54% for those 85 and older. The most common deficit was loss of ankle reflex followed by loss of fine touch. Only 40% of those with bilateral deficits reported having a disease known to cause peripheral neuropathy. Predictors of bilateral deficits included increasing age, income less than $15,000, a history of military service, increasing body mass index, self-reported history of diabetes mellitus, Vitamin B 12 deficiency or rheumatoid arthritis, and absence of a history of hypertension. Deficits were associated with numbness, pain, restless legs, trouble walking, trouble with balance, and reduced quality of life.Conclusions

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Section: Prevalence and Significancementioning

confidence: 99%

The Prevalence, Predictors, and Consequences of Peripheral Sensory Neuropathy in Older Patients

Mold

Vesely²,

Keyl³

et al. 2004

The Journal of the American Board of Family Medicine

211

135

View full text Add to dashboard Cite

show abstract

“…Patients with pre-existing conditions known to cause neuropathy (identified in the history or during basic screening by their primary care physician/during a preceding clinic appointment), were excluded from the current analysis. This explains the relatively high incidence of idiopathic neuropathy in our series (41%), compared to some previous studies, some of which, for their part, took into account all cases analyzed including genetic and inflammatory [12][13][14] which were intentionally excluded from our analysis. We considered patients with IGT amongst those with non-idiopathic neuropathy, as we believe the body of available literature currently suggests this may represent a frequent cause of distal axonal neuropathy [15].…”

Section: Discussionmentioning

confidence: 60%

Dyslipidaemia in chronic acquired distal axonal polyneuropathy

Rajabally¹,

Shah²

2011

J Neurol

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The link between hypertriglyceridaemia (HTG) and/or hypercholesterolaemia (HCL) and neuropathy is uncertain. We retrospectively reviewed records of 100 consecutive patients investigated for acquired chronic axonal distal polyneuropathy of unknown cause. Findings were compared with those of 102 consecutive controls. Patients with idiopathic neuropathy were subsequently compared with age-and gender-matched controls. There were more neuropathy patients than controls with HCL, defined as cholesterol levels [5 mmol/L (63 vs. 45.1%; p = 0.011). Neuropathy patients also had higher cholesterol levels than controls (p = 0.04). Cholesterol-lowering drug usage was similar in both groups. HTG (defined as [2 mmol/L) and triglyceride levels were comparable in both groups. HTG ranged from 2.1-4.2 mmol/L in neuropathy patients. A cause for neuropathy was identified in 59 patients. Thirty-one had impaired glucose metabolism. Forty-one had idiopathic neuropathy. No link was demonstrated between idiopathic neuropathy or painful idiopathic neuropathy, and HTG/HCL. Mean triglyceride and cholesterol levels in patients with idiopathic neuropathy were comparable to those of controls. HTG was significantly more common (p = 0.027), and triglyceride levels significantly higher (p = 0.005) in patients with neuropathy due to diabetes/impaired glucose tolerance (IGT)/ alcoholism, than in patients with neuropathy of any other cause. These results suggest HCL [5 mmol/L may represent a cofactor contributing to presence of neuropathy irrespective of the underlying cause. They on the other hand do not support mild/moderate HTG as an independent cause of neuropathy. HTG is common in patients with neuropathy associated with diabetes/IGT/chronic alcoholism, where it may play a role in peripheral nerve damage. As previously reported, IGT was in our cohort frequent, present in one case in three, in the absence of another identifiable aetiology.

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“…The incidence of idiopathic axonal neuropathy in elderly people is quite significant. Verghese et al [16] found an average incidence of 27.2 % among 402 subjects older than 65 years, 12.5 % in those younger than 75 years, 23.3 % in those younger than 84 years and 45.9 % in those older than 85 years. Interestingly, CblD was present in only 1.3 % of 213 subjects younger than 75 years and in 0.7 % of 142 subjects younger than 85 years.…”

Section: Discussionmentioning

confidence: 97%