Citation

Carrer P, Trevisan C, Curreri C, Giantin V, Maggi S, Crepaldi G, Manzato E, Sergi G. Arch. Phys. Med. Rehabil. 2018; 99(1): 137-143.e1.

Affiliation

Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.apmr.2017.08.480

PMID

28939426

Abstract

OBJECTIVES: to investigate whether Semmes Weinstein Monofilament Examination (SWME) was associated with, and could predict measures of physical performance and the risk of fall in elderly subjects.

DESIGN: prospective study (mean follow-up 4.4-years). SETTING: community. SUBJECTS: 2826 older subjects enrolled in the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study. For longitudinal analyses, we considered a subsample of 1885 persons who did not report falls at baseline. INTERVENTIONS: not applicable. MAIN OUTCOME MEASURES: falls reported in the year preceding the assessment and Short Physical Performance Battery (SPPB) were recorded at baseline and again after 4.4 years.

RESULTS: At baseline, 830 (29.4%) subjects had experienced falls in the previous year, with a higher prevalence of falls in those positive at SWME (SWME+) than in those negative at SWME (SWME-) (35.8% vs 28.0%, p=0.001). Using logistic regression, SWME+ subjects had a significant 66% higher risk of presenting worse SPPB score (95%CI: 1.51-1.83), and between 25% and 32% higher risks of having experienced at least one or recurrent falls, than those SWME-. The incidence of falls at follow-up was higher in the SWME+ compared with the SWME- group (42.2% vs 30.7%, p=0.001), and multinomial logistic regression showed that the former had a 13% higher risk of decline in SPPB scores (95%CI: 1.03-1.25), particularly for gait and balance, 48% higher risk of having had at least one fall and 77% higher risk of recurrent falls. At both baseline and follow-up, the larger the extension of neuropathy (SWME- vs unilateral vs bilateral SWME+), the greater its negative impact on falls and physical performance.

CONCLUSION: SMWE was associated with, and could predict lower-extremity physical performance and falls in older people.

Copyright © 2017. Published by Elsevier Inc.

Language: en

Keywords

aged; lower extremity; peripheral nervous system diseases