Affiliation:
1. Department of Neurology, Faculty of Medicine University of Cologne and University Hospital Cologne Cologne Germany
2. Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine University of Cologne and University Hospital Cologne Cologne Germany
3. Cognitive Neuroscience, Research Center Juelich Institute of Neuroscience and Medicine (INM‐3) Juelich Germany
4. Department of Neurology Hospital Leverkusen Leverkusen Germany
Abstract
AbstractBackground/AimsPeripheral neuropathies perturbate the sensorimotor system, causing difficulties in walking‐related motor tasks and, eventually, falls. Falls result in functional dependency and reliance on healthcare, especially in older persons. We investigated if peripheral neuropathy is a genuine risk factor for falls in the elderly and if quantification of postural control via posturography is helpful in identifying subjects at risk of falls.MethodsSeventeen older persons with a clinical polyneuropathic syndrome of the lower limbs and converging electrophysiology were compared with 14 older persons without polyneuropathy. All participants were characterized via quantitative motor and sensory testing, neuropsychological assessment, and self‐questionnaires. Video‐nystagmography and caloric test excluded vestibulocochlear dysfunction. For further analysis, all subjects were stratified into fallers and non‐fallers. Overall, 28 patients underwent computerized dynamic posturography for individual fall risk assessment. Regression analyses were performed to identify risk factors and predictive posturography parameters.ResultsNeuropathy is an independent risk factor for falls in the elderly, while no differences were observed for age, gender, weight, frailty, DemTect test, timed “Up & Go” test, and dizziness‐related handicap score. In computerized dynamic posturography, fallers stepped more often to regain postural control in challenging conditions, while the Rhythmic Weight Shift test showed a lack of anterior‐posterior bidirectional voluntary control.InterpretationOur study confirms peripheral neuropathy as a risk factor for older persons' falls. Fallers frequently used stepping to regain postural control. The voluntary control of this coping movement was impaired. Further investigations into these parameters' value in predicting the risk of falls in the elderly are warranted.