The prevalence, predictors, and consequences of peripheral sensory neuropathy in older patients

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-year-olds 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: Peripheral sensory deficits are common in the elderly. In most cases, a medical cause is not obvious. Their consequences may not be as benign as often supposed.