Peripheral neuropathy in elderly patients

Abstract

Background: Among others, a peripheral polyneuropathy lead to an increased risk for fall in elderly frail patients. Aims: Therefore, we aimed to investigate the frequency of a polyneuropathy in elderly patients treated in a specialized geriatric unit with a selected neurological expertise. Methods: Patients hospitalized for comprehensive geriatric care in our geriatric unit were selected for the analysis. For proving the presence of a polyneuropathy, we performed extended electrophysiological examinations in patients with a current fall event or at risk for falling. Results: We included in the final analysis 378 patients (median age was 82.1 years (IQR: 77.2 - 87.6 years, 64.6%were female). The diagnosis of polyneuropathy was identified in 340 patients (89.9%); in patients with a current fall event (n=173) a polyneuropathy was identified in 154 subjects (89%); in 31.5% of the cases the polyneuropathy was caused by diabetes mellitus, in 47.6% no etiology could be identified. In patients with polyneuropathy higher rates of individuals aged ≥80 years (67.1% versus 50%; p=0.038), with heart insufficiency (26.5% versus 7.9%; p=0.038) and renal insufficiency (45.6% versus 18.4%; p=0.001) were detected. The diagnosis of a polyneuropathy was associated with the factor renal insufficiency (OR: 2.680; CI: 1.100 - 6.529; p=0.03). Conclusion: Applying specific electrophysiological examinations in the particular setting of a specialized geriatric unit, we detected in a high proportion of patients a polyneuropathy (90%). Our results underline the benefit considering this approach in elderly patients at risk for fall hospitalized for comprehensive geriatric care.