Abstract
The objective of this study is to systematically review the relationship between lower-extremity peripheral nerve function and mobility in older adults. The National Library of Medicine (PubMed) was searched on March 23, 2015 with no limits on publication dates. One reviewer selected original research studies of older adults (≥65 years) that assessed the relationship between lower-extremity peripheral nerve function and mobility-related outcomes. Participants, study design and methods of assessing peripheral nerve impairment were evaluated and results were reported and synthesized. Eight articles were identified, including 6 cross-sectional and 2 longitudinal studies. These articles investigated 6 elderly cohorts (4 from the U.S. and 2 from Italy): 3 community-dwelling (including 1 with only disabled women and 1 without mobility limitations at baseline), 1 with both community-dwelling and institutionalized residents, 1 from a range of residential locations, and 1 of patients with peripheral arterial disease. Mean ages ranged from 71-82 years. Nerve function was assessed by vibration threshold (n=2); sensory measures and clinical signs and symptoms of neuropathy (n=2); motor nerve conduction (n=1); and a combination of both sensory measures and motor nerve conduction (n=3). Each study found that worse peripheral nerve function was related to poor mobility, although relationships varied based on the nerve function measure and mobility domain assessed. Six studies found that the association between nerve function and mobility persisted despite adjustment for diabetes. Evidence suggests that peripheral nerve function impairment at various levels of severity is related to poor mobility independent of diabetes. Relationships varied depending on peripheral nerve measure, which may be particularly important when investigating specific biological mechanisms. Future research needs to identify risk factors for peripheral nerve decline beyond diabetes, especially those common in late-life and modifiable. Interventions to preserve nerve function should be investigated with regard to their effect on postponing or preventing disability in older adults.
Highlights
Sensorimotor peripheral nerve function impairments are The National Health and Nutrition Survey found that common in late-life
The objective of this study is to systematically review the relationship between lower-extremity peripheral nerve function and mobility in older adults
Five studies were conducted in 4 U.S populations, 3 of these community-dwelling, including 1 of disabled women and 2 from a population with no mobility limitations at baseline
Summary
Sensorimotor peripheral nerve function impairments are The National Health and Nutrition Survey found that common in late-life These impairments are an important reduced sensation at the foot is highly prevalent among risk factor for falls in both diabetic and nondiabetic those with and without diabetes, increasing from 8.1% at individuals [1,2,3,4,5] and increasing evidence shows that they ages 40-49 to 34.7% after age 80 [6]. This is likely an are associated with mobility limitations and disability. The aim of this systematic review is to evaluate the literature on lowerextremity peripheral nerve function and mobility in studies of older adults, to identify knowledge gaps and provide recommendations for future research
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