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Peripheral neuropathy in young-old and old-old patients
J Verghese1, P L Bieri, C Gellido
1Montefiore Medical Center, Department of Neurology, Albert Einstein College of Medicine, 1165 Morris Park Avenue, Bronx, New York 10467, USA. joe_verghese@excite.com
Muscle & Nerve
|December 18, 2001
Summary
Diabetes is the leading cause of neuropathy in older adults, though its prevalence decreases in the very old. Idiopathic neuropathies become more common with advanced age, highlighting age-related differences in neuropathy causes.
Area of Science:
- Neurology
- Geriatrics
- Epidemiology
Background:
- Neuropathy is a common complication in the elderly.
- Diabetes mellitus is frequently cited as the primary cause of neuropathy in this demographic.
Purpose of the Study:
- To investigate the age-related distribution of neuropathy causes in elderly patients.
- To compare the etiological factors of neuropathy between young-old and old-old individuals.
Main Methods:
- Retrospective review of 223 young-old (65-79 years) and 77 old-old (≥80 years) patients with neuropathic symptoms.
- Prospective validation in 102 consecutive elderly patients undergoing neuropathy evaluation.
- Analysis of etiological factors, including diabetes, and electrophysiological findings.
Main Results:
- Diabetes was the most common cause of neuropathy (41%), but less frequent in the old-old (25%) compared to young-old (46%).
- Idiopathic neuropathies were significantly more prevalent in the old-old group (39%) versus the young-old group (9%).
- Alcoholic and nutritional neuropathies were infrequent in the old-old. Most neuropathies were axonal, with age showing poor correlation to electrophysiological measures.
Conclusions:
- The etiology of neuropathy in elderly patients is age-dependent.
- Idiopathic neuropathies increase in prevalence with advanced age.
- Future research should focus on the old-old population to better understand neuropathy in the elderly.
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