Volume 5 Supplement 1

3rd Congress of the International Foot and Ankle Biomechanics Community

Open Access

Idiopathic peripheral neuropathy increases fall risk in a population-based cohort study of older adults

  • Jody L Riskowski1, 2Email author,
  • Lien Quach1,
  • Brad Manor2, 3,
  • Hylton B Menz1, 2, 4,
  • Lewis A Lipsitz1, 2, 3 and
  • Marian T Hannan1, 2
Journal of Foot and Ankle Research20125(Suppl 1):P19

DOI: 10.1186/1757-1146-5-S1-P19

Published: 10 April 2012

Background

Peripheral neuropathy (PN) is often associated with specific diseases; however, research suggests that idiopathic PN is prevalent in older adult populations [1]. Foot ulceration is the traditional medical concern with PN, but people with PN may also have disproportionately more falls [2]. Therefore, our objective was to evaluate associations between PN and prospectively-ascertained falls in older adults from the population-based MOBILIZE Boston Study.

Materials and methods

Participants included 760 MOBILIZE Boston Study members. PN was assessed using Semmes-Weinstein monofilament testing [3], applying the modified Health ABC Study method [4, 5]. Three PN status groups were defined: (i) no PN (referent), (ii) PN and known disease associated with PN (e.g., diabetes, autoimmune disease) (K-PN), and (iii) idiopathic PN (I-PN). Falls were tracked through monthly fall calendars over a mean 2.8 (range 1.4-4.3) year follow-up period. Unadjusted and adjusted (age, body mass index, physical activity, prior year fall, visual acuity, depression and number of medications) gender-specific negative binomial regression models determined associations between PN and falls.

Results

I-PN was associated with a higher fall incidence in men (incidence rate ratio [IRR] 1.76 [95% confidence interval 1.00–3.09]; Figure 1) and women (1.69 [1.06–2.70]). These higher IRRs with I-PN persisted even after covariate adjustment in women (1.68 [1.09–2.60]) and men (1.70 [0.90–3.22]), with men’s confidence interval widening. K-PN was not associated with an increased incidence of falling in men and had weak, non-significant effect in women.
Figure 1

IRR between PN and falls

Conclusions

Idiopathic PN is an independent fall risk factor for women and men, suggesting that PN assessments should be included in fall risk evaluations. Future work to investigate mechanisms through which PN increases fall risk and to evaluate interventions that target fall risk in individuals with PN, such as insoles with low-grade vibrations [6], is needed.

Authors’ Affiliations

(1)
Institute for Aging Research, Hebrew SeniorLife
(2)
Harvard Medical School
(3)
Gerontology and Interdisciplinary Medicine and Biotechnology, Beth Israel Deaconess Medical Center
(4)
Musculoskeletal Research Centre, La Trobe University

References

  1. Mold JW, Vesely SK, Keyl BA, Schenk JB, Roberts M: The prevalence, predictors, and consequences of peripheral sensory neuropathy in older patients. J Am Board Fam Pract. 2004, 17: 309-318. 10.3122/jabfm.17.5.309.View ArticlePubMedGoogle Scholar
  2. Richardson JK, Hurvitz EA: Peripheral neuropathy: a true risk factor for falls. J Gerontol A Biol Sci Med Sci. 1995, 50: M211-215.View ArticlePubMedGoogle Scholar
  3. Perkins BA, Olaleye D, Zinman B, Bril V: Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care. 2001, 24: 250-256. 10.2337/diacare.24.2.250.View ArticlePubMedGoogle Scholar
  4. Strotmeyer ES, Cauley JA, Schwartz AV, de Rekeneire N, Resnick HE, Zmuda JM, Shorr RI, Tylavsky FA, Vinik AI, Harris TB, et al: Reduced peripheral nerve function is related to lower hip BMD and calcaneal QUS in older white and black adults: the Health, Aging, and Body Composition Study. J Bone Miner Res. 2006, 21: 1803-1810. 10.1359/jbmr.060725.View ArticlePubMedGoogle Scholar
  5. Leveille SG, Jones RN, Kiely DK, Hausdorff JM, Shmerling RH, Guralnik JM, Kiel DP, Lipsitz LA, Bean JF: Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA. 2009, 302: 2214-2221. 10.1001/jama.2009.1738.PubMed CentralView ArticlePubMedGoogle Scholar
  6. Liu W, Lipsitz LA, Montero-Odasso M, Bean J, Kerrigan DC, Collins JJ: Noise-enhanced vibrotactile sensitivity in older adults, patients with stroke, and patients with diabetic neuropathy. Arch Phys Med Rehabil. 2002, 83: 171-176. 10.1053/apmr.2002.28025.View ArticlePubMedGoogle Scholar

Copyright

© Riskowski et al; licensee BioMed Central Ltd. 2012

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Advertisement