Peripheral neuropathy in young-old and old-old patients.
Diabetes is said to account for most cases of neuropathy in the elderly. We reviewed records of 223 young-old (65-79 years) and 77 old-old (>or=80 years) patients referred for evaluation of neuropathic symptoms over a 9-year period. We prospectively validated our findings in 102 consecutive elderly (77 young-old) patients receiving intensive evaluation for neuropathy. Diabetes was the most common cause of neuropathy (41%), but was less common in the old-old (25% versus 46%, P < 0.001). Idiopathic neuropathies were more common in the old-old (39% versus 9%, P < 0.001). Alcoholic and nutritional neuropathies were uncommon in the old-old. Electrophysiological studies showed that most patients had an axonal type of neuropathy. Sural and peroneal response amplitudes were poorly correlated with age. We obtained similar results in our prospective study. The distribution of causes of neuropathies in young-old and old-old patients, in a hospital-based sample, is age-related. Future studies need to include the old-old to better understand the nature of neuropathy in the elderly.
Verghese
J
J
Montefiore Medical Center, Department of Neurology, Albert Einstein College of Medicine, 1165 Morris Park Avenue, Bronx, New York 10467, USA. joe_verghese@excite.com
Bieri
P L
PL
Gellido
C
C
Schaumburg
H H
HH
Herskovitz
S
S
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D020269:Alcoholic Neuropathy / Q000175:diagnosis / Q000453:epidemiology; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology; D064420:Drug-Related Side Effects and Adverse Reactions; D005500:Follow-Up Studies; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies