ArticlesThe clinical identification of peripheral neuropathy among older persons☆,☆☆,★,★★,♢
Section snippets
Participants
The control and peripheral neuropathy subjects were examined as part of a screening process for other studies that investigated the effects of peripheral neuropathy on postural stability among older persons. The majority of the peripheral neuropathy and all of the control subjects had been referred to the electrodiagnostic laboratory by their primary physicians for symptoms and/or signs consistent with a lower-extremity peripheral neurologic disorder. Reasons for referral for the 68 peripheral
Results
One hundred subjects were included in the analyses. Sixty-eight of the subjects were in the peripheral neuropathy group, and 32 were in the control group. Although there were no group differences in age, gender, or BMI, the peripheral neuropathy subjects were significantly taller and heavier than the control subjects (table 1).Empty Cell With PN (n=68) Without PN (n=32) P* Mean age ± SD (y) 65.6±9.0 67.4±8.8 .359 Gender, n (% women)
Discussion
The boundary between normal peripheral nerve function and peripheral neuropathy is not always distinct, and this is particularly true for older patients. The present study identified peripheral neuropathy by using electrodiagnostic results as the standard. Although electrodiagnostic studies are imperfect, they are generally accepted and do not require sustained concentration or attention on the part of the patient, representing an advantage for the older patient population studied here. Despite
Conclusion
Peripheral neuropathy is common among older persons, and its detection is clinically relevant. This study found a strong correlation between semiquantitative physical examination techniques and the presence of peripheral neuropathy determined electrodiagnostically. However, as with all studies, these findings should be replicated by others before widespread clinical use is considered. The examination techniques described cannot replace electrodiagnostic studies that, unlike the physical
Acknowledgements
I thank Ken Guire for his patience and expertise while providing statistical consultation.
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Supported by the US Public Health Service (grant nos. K23 AG 00989-01, 1P30 AG 08808).
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Reprint requests to James K. Richardson, MD, Dept of Physical Medicine and Rehabilitation, University of Michigan Medical Center, MPB D5200, Ann Arbor, MI 48109-0718, e-mail: [email protected].
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