title: Mobility-Related Consequences of Reduced Lower-Extremity Peripheral Nerve Function with Age: A Systematic Review.
abstract: The objective of this study is to systematically review the relationship between lower-extremity peripheral nerve function and mobility in older adults. The National Library of Medicine (PubMed) was searched on March 23, 2015 with no limits on publication dates. One reviewer selected original research studies of older adults (≥65 years) that assessed the relationship between lower-extremity peripheral nerve function and mobility-related outcomes. Participants, study design and methods of assessing peripheral nerve impairment were evaluated and results were reported and synthesized. Eight articles were identified, including 6 cross-sectional and 2 longitudinal studies. These articles investigated 6 elderly cohorts (4 from the U.S. and 2 from Italy): 3 community-dwelling (including 1 with only disabled women and 1 without mobility limitations at baseline), 1 with both community-dwelling and institutionalized residents, 1 from a range of residential locations, and 1 of patients with peripheral arterial disease. Mean ages ranged from 71-82 years. Nerve function was assessed by vibration threshold (n=2); sensory measures and clinical signs and symptoms of neuropathy (n=2); motor nerve conduction (n=1); and a combination of both sensory measures and motor nerve conduction (n=3). Each study found that worse peripheral nerve function was related to poor mobility, although relationships varied based on the nerve function measure and mobility domain assessed. Six studies found that the association between nerve function and mobility persisted despite adjustment for diabetes. Evidence suggests that peripheral nerve function impairment at various levels of severity is related to poor mobility independent of diabetes. Relationships varied depending on peripheral nerve measure, which may be particularly important when investigating specific biological mechanisms. Future research needs to identify risk factors for peripheral nerve decline beyond diabetes, especially those common in late-life and modifiable. Interventions to preserve nerve function should be investigated with regard to their effect on postponing or preventing disability in older adults.
authors: 1Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA; 2School of Public Health, Boston University, Boston, MA 00218, USA.
authors: Rachel E
authors: RE
authors: Ward
authors: 3Department of Sports Science and Clinical Biomechanics, University of Southern, Denmark, Odense, Denmark.
authors: Paolo
authors: P
authors: Caserotti
authors: 4Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA.
authors: Jane A
authors: JA
authors: Cauley
authors: 4Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA.
authors: Robert M
authors: RM
authors: Boudreau
authors: 5Sanford Burnham Medical Research Institute, Orlando, FL 32827, USA.
authors: Bret H
authors: BH
authors: Goodpaster
authors: 6Department of Neurobiology, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
authors: Aaron I
authors: AI
authors: Vinik
authors: 4Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA.
authors: Anne B
authors: AB
authors: Newman
authors: 4Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA.
authors: Elsa S
authors: ES
authors: Strotmeyer
keywords: aging; disability; mobility limitation; older adults; peripheral nerve function; sensory function