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The Relationship of Reduced Peripheral Nerve Function and Diabetes With Physical Performance in Older White and Black Adults

The Health, Aging, and Body Composition (Health ABC) Study

  1. Elsa S. Strotmeyer, PHD, MPH1,
  2. Nathalie de Rekeneire, MD2,
  3. Ann V. Schwartz, PHD3,
  4. Kimberly A. Faulkner, PHD1,
  5. Helaine E. Resnick, PHD4,
  6. Bret H. Goodpaster, PHD5,
  7. Ronald I. Shorr, MD6,
  8. Aaron I. Vinik, MD7,
  9. Tamara B. Harris, MD8,
  10. Anne B. Newman, MD, MPH9 and
  11. for the Health ABC Study
  1. 1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
  2. 2Epicentre, Paris, France
  3. 3Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
  4. 4American Association of Homes and Services for the Aging, Washington, DC
  5. 5Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  6. 6Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, and Department of Aging and Geriatrics, University of Florida, Gainesville, Florida
  7. 7Eastern Virginia Medical School, Norfolk, Virginia
  8. 8Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
  9. 9Department of Epidemiology and Division of Geriatric Medicine, University of Pittsburgh Graduate School of Public Health and School of Medicine, Pittsburgh, Pennsylvania
  1. Corresponding author: Elsa S. Strotmeyer, strotmeyere{at}edc.pitt.edu

Abstract

OBJECTIVE—Poor peripheral nerve function is prevalent in diabetes and older populations, and it has great potential to contribute to poor physical performance.

RESEARCH DESIGN AND METHODS—Cross-sectional analyses were done for the Health, Aging, and Body Composition (Health ABC) Study participants (n = 2,364; 48% men; 38% black; aged 73–82 years). Sensory and motor peripheral nerve function in legs/feet was assessed by 10- and 1.4-g monofilament perception, vibration detection, and peroneal motor nerve conduction amplitude and velocity. The Health ABC lower-extremity performance battery was a supplemented version of the Established Populations for the Epidemiologic Studies of the Elderly battery (chair stands, standing balance, and 6-m walk), adding increased stand duration, single foot stand, and narrow walk.

RESULTS—Diabetic participants had fewer chair stands (0.34 vs. 0.36 stands/s), shorter standing balance time (0.69 vs. 0.75 ratio), slower usual walking speed (1.11 vs. 1.14 m/s), slower narrow walking speed (0.80 vs. 0.90 m/s), and lower performance battery score (6.43 vs. 6.93) (all P < 0.05). Peripheral nerve function was associated with each physical performance measure independently. After addition of peripheral nerve function in fully adjusted models, diabetes remained significantly related to a lower performance battery score and slower narrow walking speed but not to chair stands, standing balance, or usual walking speed.

CONCLUSIONS—Poor peripheral nerve function accounts for a portion of worse physical performance in diabetes and may be directly associated with physical performance in older diabetic and nondiabetic adults. The impact of peripheral nerve function on incident disability should be evaluated in older adults.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 5 June 2008.

    A.I.V. serves as a consultant for Neurometrix, R.W. Johnson Pharmaceutical Research Institute, Takeda, TEVA Pharmaceutical Industries, AstraZeneca, sanofi aventis, DLife, Health ABC, Mitsubishi Pharma America, and Paramount Biosciences.

    Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted May 27, 2008.
    • Received February 29, 2008.
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This Article

  1. Diabetes Care September 2008 vol. 31 no. 9 1767-1772
  1. All Versions of this Article:
    1. dc08-0433v1
    2. 31/9/1767 most recent
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