Diabetes, peripheral neuropathy, and old age disability

Area of Science:

• Gerontology
• Neurology
• Diabetology

Background:

• Diabetes is associated with disability in older adults.
• Peripheral neuropathy is a common complication of diabetes.
• The role of peripheral neuropathy in diabetes-related disability requires further investigation.

Purpose of the Study:

• To determine if peripheral neuropathy explains the association between diabetes and disability in older adults.
• To evaluate lower extremity function tests in older diabetic adults with and without neuropathy.

Main Methods:

• 39 adults (aged 70-79) were evaluated: 14 with diabetic neuropathy (DN), 13 diabetic controls (DC), and 12 non-diabetic controls (NDC).
• Measures included pressure sensation, vibration perception threshold (VPT), and peroneal nerve electrophysiologic function.
• Neuropathy measures were correlated with walking speed, balance, coordination, and ankle strength tests.

Main Results:

• Diabetic neuropathy (DN) subjects showed significantly impaired sensory and electrophysiologic measures compared to non-diabetic controls (NDC).
• DN subjects performed significantly worse on tests of walking speed, static and dynamic balance, and coordination compared to NDC.
• No significant differences in neuropathy measures or physical performance were found between diabetic controls (DC) and non-diabetic controls (NDC).

Conclusions:

• Peripheral neuropathy is a key factor contributing to physical disability in older adults with diabetes.
• Quantitative sensory and motor nerve function measures have distinct impacts on physical performance.
• Interventions for diabetes-associated disability should prioritize individuals with peripheral neuropathy.