Faculty Opinions recommendation of Expenditures in the elderly with peripheral neuropathy: Where should we focus cost-control efforts?

Peripheral nerves are susceptible to damage by a wide array of toxins, medications, and vitamin deficiencies. Vitamin B12 (VB12) deficiency neuropathy is a rare debilitating disease that affects mostly the elderly. It is important to consider these etiologies when approaching patients with a variety of neuropathic presentations in this review were have included most relevant and latest information on mechanisms causing Peripheral neuropathy in VB12 deficiency. We also have included cardiovascular disorders and their management. Hyperhomocysteinemia has been implicated in endothelial dysfunction and cardiovascular disease. The association of homocysteine (Hcy) and VB12 with cardiovascular risk factors in patients with coronary artery disease (CAD) has also been studied Keywords: Peripheral Neuropathy, Vitamin B12 Deficiency, Cardiovascular Disease and Homocysteine.

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Further Investigation of the Negative Association between Hypertension and Peripheral Neuropathy in the Elderly: An Oklahoma Physicians Resource/Research Network (OKPRN) Study

The Journal of the American Board of Family Medicine ◽

10.3122/jabfm.19.3.240 ◽

2006 ◽

Vol 19 (3) ◽

pp. 240-250 ◽

Cited By ~ 16

Author(s):

D. Y. Cho ◽

J. W. Mold ◽

M. Roberts

Keyword(s):

Peripheral Neuropathy ◽

The Elderly ◽

Negative Association ◽

Research Network ◽

Resource Research

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Falls in the Elderly: Identifying and Managing Peripheral Neuropathy

The Nurse Practitioner ◽

10.1097/00006205-200103000-00009 ◽

2001 ◽

pp. 86-88 ◽

Cited By ~ 4

Author(s):

Dorothy J. Zaida ◽

Mary K. Alexander

Keyword(s):

Peripheral Neuropathy ◽

The Elderly

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“Concealed Renal Insufficiency” Leading to ADRs in the Elderly; Vincristine-Induced Peripheral Neuropathy – Worse after Drug Discontinuation; Gadolinium Encephalopathy in a Patient with Renal Failure; Herbal Preparation Causes Retinal Vein Thrombosis; Sweet Syndrome Associated with Imatinib Therapy; Risperidone-Induced Morning “Pseudoneutropenia”; Venlafaxine-Associated Interstitial Pneumonitis

Hospital Pharmacy ◽

10.1177/001857870504000603 ◽

2005 ◽

Vol 40 (6) ◽

pp. 478-482

Author(s):

Joel Shuster

Keyword(s):

Renal Failure ◽

Peripheral Neuropathy ◽

Renal Insufficiency ◽

Interstitial Pneumonitis ◽

The Elderly ◽

Drug Discontinuation ◽

Herbal Preparation ◽

Drug Reactions ◽

Sweet Syndrome ◽

Vein Thrombosis

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), to discuss methods of prevention, and to promote reporting of ADRs to the FDA's medwatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medwatch, please consider sharing the account with our readers.

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Neuropathies in the older patient

Reviews in Clinical Gerontology ◽

10.1017/s0959259807002080 ◽

2006 ◽

Vol 16 (2) ◽

pp. 113-124 ◽

Cited By ~ 2

Author(s):

Yusuf A Rajabally

Keyword(s):

Nervous System ◽

Peripheral Neuropathy ◽

Peripheral Nervous System ◽

Peripheral Nerves ◽

Elderly Population ◽

Natural Aging ◽

The Elderly ◽

Impaired Glucose Metabolism ◽

Older Patient ◽

Target Organs

Peripheral neuropathy encompasses disorders of the peripheral nervous system, affecting the axon and/or the myelin sheath. The prevalence of peripheral neuropathy increases with age. Thought to be of about 3000 per 100 000 in adults generally, this figure could be as high as 8000 above the age of 60 years. However more than half of these cases would be due to impaired glucose metabolism in its various forms. In the remainder, an aetiology may be found in about 70% of cases. The elderly population is at higher risk of peripheral neuropathy, as there is a correlation between age and impairment of the peripheral nervous system. The natural aging process affects adversely the function of peripheral nerves and of their target organs, resulting in the development of motor, sensory and autonomic symptoms in the absence of additional damage of other causes. In addition, the increased prevalence of chronic systemic disorders causing neuropathy, as well as the use of neurotoxic drugs in older patients, contribute to the onset of neuropathy.

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LXR agonist Prevents Peripheral Neuropathy and modifies PNS immune cells in Aged Mice

10.1101/2021.09.22.461263 ◽

2021 ◽

Author(s):

Chaitanya Gavini ◽

Nadia Elshareif ◽

Anand Germanwala ◽

Gregory Aubert ◽

Nigel Calcutt ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Immune Cell ◽

The Elderly ◽

Cholesterol Content ◽

Nerve Fibers ◽

Aged Mice ◽

Diet Induced Obesity ◽

Age Related ◽

Potent Agonist ◽

Progressive Disorder

Peripheral neuropathy is a common and progressive disorder in the elderly that interferes with daily activities and increases the risk of injury. It is of importance to find efficient treatments to treat or delay this age-related neurodegeneration. We previously demonstrated that activation of the cholesterol sensor Liver X receptor (LXR) with the potent agonist GW3965, alleviates pain in a diet-induced obesity model. Because cholesterol had also been linked to neuropathy during aging, we sought to test whether LXR activation may improve neuropathy and pain in aged mice by treating 21-month-old mice for 3 months with GW3965. Treatment resulted in a significant increase in nerve fibers of the sub-basal plexus, accompanied by a change in polarization, metabolism, and cholesterol content of macrophages in the sciatic nerve. These results suggest that activation of the LXR may block the progression of neuropathy associated with aging by modifying nerve-immune cell cholesterol, thereby providing new pathways to target in efforts to delay neuropathy during aging.

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Diabetic Peripheral Neuropathy Affects Pinch Strength and Hand Dexterity in Elderly Patients

Neural Plasticity ◽

10.1155/2021/9959103 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Qi Zhang ◽

Yifang Lin ◽

Xinhua Liu ◽

Li Zhang ◽

Yan Zhang ◽

...

Keyword(s):

Peripheral Neuropathy ◽

Elderly Patients ◽

Diabetic Peripheral Neuropathy ◽

Hand Function ◽

The Elderly ◽

Pinch Strength ◽

Diabetic Patients ◽

Sensory Threshold ◽

Dominant Hand ◽

Hand Dexterity

Objective. Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes, leading to disability and decreased quality of life. In past research and clinical studies, the lower limb function of DPN patients was often the principal subject of research, with little attention given to the upper limb and hand. Our goal was to assess and compare hand function between elderly diabetic patients with DPN and without DPN. Methods. A total of 52 diabetic patients were registered and underwent hand function assessments and electrodiagnostic tests. Dynamometer, pinch meter, Semmes Weinstein monofilaments, and the Purdue Pegboard Test (PPT) were used to assess the patients’ grip strength, pinch strength, tactile sensory threshold, and hand dexterity. Results. Compared with the non-DPN group, the elderly DPN group showed worse thumb-middle fingertip pinch strength and thumb-little fingertip pinch strength in the dominant hand (3.50 (2.50, 4.25) vs. 4.50 (3.00, 5.00), p = 0.019 ; 1.50 (1.00, 2.00) vs. 2.50 (2.00, 3.00), p < 0.001 ); the elderly DPN group displayed worse thumb-middle fingertip pinch strength, thumb-ring fingertip pinch strength, and thumb-little fingertip pinch strength in the nondominant hand (3.50 (2.00, 4.50) vs. 4.00 (3.00, 5.00), p = 0.013 ; 2.50 (1.25, 3.00) vs. 3.00 (2.50, 3.50), p = 0.033 ; 1.00 (0.75, 2.25) vs. 2.50 (2.00, 2.50), p < 0.001 ). The elderly DPN group scored lower than the non-DPN group on the PPT test of assembly ( 13.96 ± 5.18 vs. 16.96 ± 4.61 , t = 2.212 , p = 0.032 ). Conclusion. Motor function limitation is the principal hand dysfunction in elderly patients with DPN, which is mainly manifested as a decline in fingertip pinch strength and a decrease in hand dexterity. This trial is registered with Clinical Trial Registry no. ChiCTR1900025358.

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Diabetic footwear: is it an assistive technology capable of reducing peak plantar pressures in elderly patients with neuropathy?

Fisioterapia em Movimento ◽

10.1590/1980-5918.029.003.ao04 ◽

2016 ◽

Vol 29 (3) ◽

pp. 469-476 ◽

Cited By ~ 1

Author(s):

Alexandre Faraco de Oliveira ◽

Ana Carolina Bertoletti De Marchi ◽

Camila Pereira Leguisamo

Keyword(s):

Peripheral Neuropathy ◽

Assistive Technology ◽

Plantar Pressure ◽

The Elderly ◽

Test Results ◽

Paired Sample ◽

Plantar Pressures ◽

Therapeutic Footwear ◽

High Prevalence ◽

Peak Plantar Pressure

Abstract Introduction: Diabetes Mellitus is a chronic disease with high prevalence in the population in particular among the elderly. The longer time of diabetes, increased the chances of developing complications such as peripheral neuropathy, which is an important factor in the genesis of plantar lesions by changing the distribution and formation of plantar pressure peaks. Objective: Evaluate the influence of an Assistive Technology, therapeutic footwear for diabetics, in the peaks of plantar pressure of elderly. Methods: This was an experimental study of transversal type, composed by 10 elderly, diabetic, with peripheral neuropathy, using as an instrument to measure a baropodometry platform. Were measured peaks of plantar pressure, static and dynamic in three situations: barefoot, the participants' own standard footwear and with therapeutic footwear for diabetics. Data analysis by normal distribution as a single paired sample, applying the ANOVA test. Results: The use of therapeutic footwear for diabetics promoted a reduction in media of peak plantar pressure in the order of 22% in static analysis, and 31% in dynamic analysis. Conclusion: The therapeutic footwear for diabetics was able to produce significant reductions in peak plantar pressure, being more efficient than a common footwear. This effect may contribute to the prevention of injuries associated with the diabetic foot.

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