The health consequences of peripheral neurological deficits in an elderly cohort: an Oklahoma Physicians Resource/Research Network Study.
OBJECTIVE
To determine whether the belief that loss of deep tendon reflexes and vibratory sensation in the ankles in older patients is of no great consequence is valid.


METHODS
Four-year longitudinal cohort study.


METHODS
Primary care practice-based research network.


METHODS
Six hundred four noninstitutionalized individuals aged 65 and older with no self-reported medical conditions known to cause peripheral neuropathy (PN), recruited from the practices of 23 primary care physicians in central Oklahoma.


METHODS
Annual standardized peripheral neurological examination performed by two research nurses plus a questionnaire that included self-reported measures of health, health-related quality of life (HRQoL Quality of Well-Being--Self Administered (QWB-SA) and Health Utilities Index-3 (HUI-3), physical functioning--(Medical Outcomes Study 36-item Short Form Survey (SF-36)), falls, and use of healthcare services. Deaths were determined from participant contacts, primary care physicians, and the Social Security death index.


RESULTS
One hundred sixty of 604 participants had symmetrical peripheral neurological deficits (SPNDs). After controlling for age, sex, race, education, income, body mass index, HRQoL, physical functioning, self-rated health, cognitive test score, and a variety of medical conditions, SPNDs were associated with earlier hospitalization (P=.03); greater mortality (P<.001); and declines in HRQoL (QWB-SA, P<.001), self-rated health (P=.02) physical functioning (SF-36, P=.005), and bodily pain (SF-36, P=.001).


CONCLUSIONS
SPNDs of undetermined cause, found in older patients on physical examination, appear to be associated with greater morbidity and mortality.
Mold
James W
JW
University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA. james-mold@ouhsc.edu
Lawler
Frank
F
Roberts
Michelle
M
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D009825:Oklahoma; D010523:Peripheral Nervous System Diseases / Q000145:classification / Q000150:complications* / Q000175:diagnosis; D016016:Proportional Hazards Models; D011788:Quality of Life; D012923:Social Class; D011795:Surveys and Questionnaires; D016138:Walking