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

James W. Mold; Sara K. Vesely; Barbara A. Keyl; Joan B. Schenk; Michelle Roberts

doi:10.3122/jabfm.17.5.309

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Table 1.

Characteristics of Participants with Peripheral Neuropathy (PN) (N = 795)

Variables	N	PN	P
Age	795		.0001
65 to 74	494	26%
75 to 84	262	36%
≥85	39	54%
Body Mass Index:			.0017
>30	264	38%
<30	531	27%
Gender	795		.2053
Female	453	29%
Male	342	33%
Race/Ethnicity	795		.6965
White	683	31%
African American	68	28%
Native American	32	41%
Hispanic	10	30%
Asian/Pacific Islander	2	0%
Education	793		.0387
<High School	120	37%
High School	450	27%
>High School	223	35%
Income	763		.0061
<$15,000 per year	138	41%
$15,000 to $35,000 per year	338	32%
>$35,000	287	25%
History of Military Service	787		.0316
Yes	263	36%
No	524	28%
Current use of alcohol	795		.6150
None	595	32%
1 to 5 drinks per week	140	29%
6 to 10 drinks per week	34	29%
≥11 drinks per week	20	20%
Current use of tobacco	795		.4079
Yes	80	35%
No	715	30%
PN Diseases
Diabetes			<.0001
Yes	133	47%
No	662	28%
B₁₂ deficiency			.0285
Yes	41	46%
No	754	30%
Autoimmune disease			.0026
Yes	50	50%
No	745	30%
Chronic Hepatitis B or C			.7456
Yes	11	36%
No	784	31%
Hereditary neuropathy			.1751
Yes	5	60%
No	790	31%
Crohn disease			1.00
Yes	7	29%
No	788	31%
Other Medical Conditions
Osteoarthritis			.8311
Yes	158	32%
No	637	31%
Hypertension			.1228
Yes	362	28%
No	433	33%
Hypercholesterolemia			.1902
Yes	285	28%
No	510	22%
Thyroid Problem			.4246
Yes	122	28%
No	673	31%

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Table 2.

Prevalence of Peripheral Neuropathy (PN) by Age Group and Presence of a Disease Known to Cause PN

Age Group	Patients with PN (n = 246)		All
Age Group	No PN Disease	PN Disease*
65 to 74	19.3 (69/357)	43 % (61/143)	26 % (130/494)
75 to 84	31 % (61/194)	50 % (34/68)	36 % (95/262)
≥85	58 % (18/31)	38 % (3/8)	54 % (21/39)
≥65 (All)	26 % (148/576)	45 % (98/219)	31 % (246/795)

PN disease, self-reported history of diabetes mellitus, vitamin B₁₂ deficiency, chronic hepatitis, Crohn disease, systemic lupus, scleroderma, rheumatoid arthritis, hereditary neuropathy, neurofibromatosis, or sarcoidosis. Association (χ²) between PN and PN disease (P < .0001). Association (Fisher’s exact test) between age group and PN; for those without PN disease, P < .0001; for those with PN disease, P = .5918.

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Table 3.

Distribution of Neurologic Deficits in Participants with Peripheral Neuropathy (N = 246)

Deficit(s)	% (Number with Deficits)
1 deficit	71 (175)
Ankle reflex only	59 (145)
Position only	1 (3)
Touch only	9 (22)
Vibration only	2 (5)
2 deficits	22 (53)
Ankle and position	1 (3)
Ankle and touch	11 (28)
Ankle and vibration	4 (10)
Position and touch	2 (6)
Touch and vibration	2 (6)
3 deficits	7 (16)
Ankle, position, & touch	0.4 (1)
Ankle, position, & vibration	1 (2)
Ankle, touch, & vibration	5 (12)
Position, touch, and vibration	0.4 (1)
4 deficits	1 (2)
Touch (small fibers) involved	32 (78)
Position involved	7 (18)
Vibration involved	15 (38)
Ankle reflex involved	78 (191)

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Table 4.

Factors Associated with Peripheral Neuropathy after Controlling for All Other Variables in a Logistic Regression Model

Variables	Odds Ratio	95% Confidence Interval
Age	1.08/year	1.05 to 1.11
Body mass index	1.06/unit	1.03 to 1.10
Military service	1.80	1.24 to 2.62
Rheumatoid arthritis	2.92	1.49 to 5.73
Vitamin B₁₂ deficiency	2.37	1.16 to 4.84
Hypertension	0.63	0.44 to 0.89
Diabetes mellitus	2.71	1.67 to 4.39	If income <$15,000/yr
	1.18	0.87	If income $15,000–$35,000/yr
	1.77	1.40 to 2.25	If income >$35,000/yr

Note: Hosmer-Lemeshow Goodness of Fit test had χ² of 5.5152, P = .7014 (8 df).

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Table 5.

Associations between 1 or More and 2 or More Bilateral Peripheral Neurologic Deficits and Various Outcomes after Adjusting for Age, Gender, Race, Education, Income, Body Mass Index, and Presence of Disease Known to Cause Peripheral Neuropathy

Outcome Variables	1 + Deficit	2 + Deficits
Symptoms
Numbness arms/legs	1.44 (0.97, 2.14)	2.74 (1.56, 4.79)^*
Pain or discomfort	1.68 (1.19, 2.37)^*	1.80 (1.03, 3.16)^*
Restless legs	1.40 (0.96, 2.04)	2.15 (1.23, 3.74)^*
Trouble walking	1.50 (1.04, 2.17)^*	2.62 (1.47, 4.67)^*
Trouble with balance	1.64 (1.11, 2.43)^*	2.65 (1.50, 4.70)^*
Falls in last 3 months
One fall	1.22 (0.80, 1.84)	1.07 (0.56, 2.03)
≥2 falls	1.53 (0.83, 2.81)	1.17 (0.46, 2.97)
Objective Findings
Tinetti Balance Score (0 to 16)	−1.12 (−1.54, −0.70)^*	−1.58 (−2.26, −0.91)^*
Timed 50−ft walk (seconds)	−0.12 (−1.15, 0.91)	−0.08 (−1.73, 1.56)
QOL/Functional Status
Self rated health (0 to 100)	−0.82 (−3.53, 1.89)	−2.55 (−6.87, 1.77)
SF-36 General Health (0 to 100)	−2.42 (−5.47, 2.63)	−6.65 (−11.48, −1.83)^*
SF-36 Physical Functioning(0 to 100)	−7.06 (−11.01, −3.10)^*	−10.54 (−16.89, −4.18)^*
SF-36 Role Physical (0 to 100)	−5.09 (−11.73, 1.55)	−8.16 (−18.76, 2.44)
SF-36 Bodily Pain (0 to 100)	−3.36 (−7.22, 0.49)	−5.96 (−12.09, 0.17)
QWB-SA (0 to 1)	−0.027 (−0.047, −0.006)^*	−0.028 (−0.61, 0.004)
HUI-3 (0 to 1)	−0.039 (−0.074, −0.004)^*	−0.046 (−0.102, 0.010)

Odds ratios and 95% confidence intervals derived from logistic regression models are given for symptoms β coefficients and 95% confidence intervals derived from linear regression models are given for objective findings and QOL/functional status. Numbers are odds ratios (95% confidence intervals) for symptom variables and β coefficients (95% confidence intervals) for all other variables.
* P < .05
QWB-SA, Quality of Well Being–Self-Administered Scale; HUI-3, Healthy Utility Index 3 Scale.