Clinical Question: in what way com...

Clinical Question: in what way common are peripheral sensory deficits in somewhat old patients?

Setting: Outpatient (primary care)

studious mood Design: Descriptive

Synopsis: Investigators chronicleed patients 65 years or older from the practices of family physicians in the Oklahoma Physicians Resource/Research Network. Patients who agreed to participate complet a questionnaire about demographic information, health habits, medical conditions, symptoms, fresh falls, functional status, and health-related quality of life. At the enrollment visit, undivided of two research nurses trained by dint of a neurologist performed the peripheral neurologic examination. The assessment included the personality or absence of deep tendon reflexe at the ankles, position intellect at the great toes, vibratory brains at the medial malleoli, fine-touch sensation in the alones of the feet, balance examination, and a timed distance walk. Peripheral neuropathy was defined as the appearance of one or more ended bilateral deficits.

The 799 consenting enslaves who met inclusion criteria were more likely than nonparticipants to be men younger, better educated, in better health, and white. The mean age of participants was 734 years (range = 64 to 94 years). More than the same fourth (27.5 percent) gave a history of at least individual disease known to cause peripheral neuropathy. The prevalence of at least single bilateral sensory deficit increased from 26 percent for 65- to 74-year-old patients to 54 percent for those 85 years and older The principally common bilateral deficit was the absence of ankle reflexe (86 percent of those with deficits), followed according to insensitivity to touch (31 percent) vibration (15 percent) and position (7 percent) Factors associated with sensory deficits included increasing age, incomes of les than $15000 a history of military service, higher carcass mass index, diabetes mellitus, vitamin [Bsub12] deficiency, rheumatoid arthritis, and the absence of hypertension. Patients with common or more deficits frequently reported numbnes of extremities (28 percent) pain or discomfort (48 percent) restles leg (31 percent) perturb walking (44 percent), and agitate with balance (35 percent).

Bottom Line: Peripheral sensory deficits are for the use of all in the elderly, present in 26 percent of patients 65 to 74 years of age and increasing to 54 percent for those 85 years and older many times there is no obvious associated medical cause. Because patients registered in this study were clearly younger and healthier than those declining to participate, the loyal prevalence of peripheral neuropathy in this population may be flat higher. (Level of Evidence: 3b)

reflection Reference: Mold JW, et al. The prevalence, predictors, and chain of cause and effects of peripheral sensory neuropathy in older patients. J Am Board Fam Pract September-October 2004;17:309-18

Used with permission from Slawson D Peripheral sensory deficits for the use of all in elderly. Accessed online November 1 2004 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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