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Sensory and Motor Peripheral Nerve Function and Incident Mobility Disability
Author(s) -
Ward Rachel E.,
Boudreau Robert M.,
Caserotti Paolo,
Harris Tamara B.,
Zivkovic Sasa,
Goodpaster Bret H.,
Satterfield Suzanne,
Kritchevsky Stephen B.,
Schwartz Ann V.,
Vinik Aaron I.,
Cauley Jane A.,
Simonsick Eleanor M.,
Newman Anne B.,
Strotmeyer Elsa S.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.13152
Subject(s) - medicine , interquartile range , prospective cohort study , population , body mass index , motor nerve , physical medicine and rehabilitation , diabetes mellitus , physical therapy , anatomy , environmental health , endocrinology
Objectives To assess the relationship between sensorimotor nerve function and incident mobility disability over 10 years. Design Prospective cohort study with longitudinal analysis. Setting Two U . S . clinical sites. Participants Population‐based sample of community‐dwelling older adults with no mobility disability at 2000/01 examination (N = 1,680; mean age ± SD 76.5 ± 2.9, body mass index 27.1 ± 4.6; 50.2% female, 36.6% black, 10.7% with diabetes mellitus). Measurements Motor nerve conduction amplitude (poor <1 mV ) and velocity (poor <40 m/s) were measured on the deep peroneal nerve. Sensory nerve function was measured using 10‐ and 1.4‐g monofilaments and vibration detection threshold at the toe. Lower extremity symptoms included numbness or tingling and aching or burning pain. Incident mobility disability assessed semiannually over 8.5 years (interquartile range 4.5–9.6 years) was defined as two consecutive self‐reports of a lot of difficulty or inability to walk one‐quarter of a mile or climb 10 steps. Results Nerve impairments were detected in 55% of participants, and 30% developed mobility disability. Worse motor amplitude ( HR = 1.29 per SD , 95% CI = 1.16–1.44), vibration detection threshold ( HR = 1.13 per SD , 95% CI = 1.04–1.23), symptoms ( HR = 1.65, 95% CI = 1.26–2.17), two motor impairments ( HR = 2.10, 95% CI = 1.43–3.09), two sensory impairments ( HR = 1.91, 95% CI = 1.37–2.68), and three or more nerve impairments ( HR = 2.33, 95% CI = 1.54–3.53) predicted incident mobility disability after adjustment. Quadriceps strength mediated relationships between certain nerve impairments and mobility disability, although most remained significant. Conclusion Poor sensorimotor nerve function independently predicted mobility disability. Future work should investigate modifiable risk factors and interventions such as strength training for preventing disability and improving function in older adults with poor nerve function.