Brittney S Lange-Maia1, Anne B Newman2, John M Jakicic3, Jane A Cauley4, Robert M Boudreau1, Ann V Schwartz5, Eleanor M Simonsick6, Suzanne Satterfield7, Aaron I Vinik8, Sasa Zivkovic9, Tamara B Harris10, Elsa S Strotmeyer11. 1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Bellefield Ave., 5th Floor, Pittsburgh, PA 15213, United States. 2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Desoto Street., A528 Crabtree Hall, Pittsburgh, PA 15261, United States. 3. Department of Health and Physical Activity, School of Education, University of Pittsburgh, Oak Hill Commons, 32 Oak Hill Court, Pittsburgh, PA 15261, United States. 4. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Desoto Street, A510 Crabtree Hall, Pittsburgh, PA 15261, United States. 5. Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA 94158, United States. 6. Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, 251 Bayview Boulevard, Suite 100, Baltimore, MD 21224, United States. 7. Department of Preventive Medicine, University of Tennessee Health Science Center, 649 Doctor's Office Building, 66 N. Pauline St., Memphis, TN 38163, United States. 8. Department of Neurobiology, Eastern Virginia Medical School, 855 W. Brambleton Avenue, Norfolk, VA 23510, United States. 9. Department of Neurology, University of Pittsburgh, 3471 Fifth Ave. Suite 810, Pittsburgh, PA 15213, United States. 10. Intramural Research Program, Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, National Institutes of Health, Laboratory of Epidemiology, Demography, and Biometry, Gateway Building, 3C309, 7201 Wisconsin Avenue, Bethesda, MD 20892, United States. 11. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 N. Bellefield Ave., 5th Floor, Pittsburgh, PA 15213, United States. Electronic address: StrotmeyerE@edc.pitt.edu.
Abstract
BACKGROUND: Age-related peripheral nervous system (PNS) impairments are highly prevalent in older adults. Although sensorimotor and cardiovascular autonomic function have been shown to be related in persons with diabetes, the nature of the relationship in general community-dwelling older adult populations is unknown. METHODS: Health, Aging and Body Composition participants (n=2399, age=76.5±2.9years, 52% women, 38% black) underwent peripheral nerve testing at the 2000/01 clinic visit. Nerve conduction amplitude and velocity were measured at the peroneal motor nerve. Sensory nerve function was assessed with vibration detection threshold and monofilament (1.4-g/10-g) testing at the big toe. Symptoms of lower-extremity peripheral neuropathy were collected by self-report. Cardiovascular autonomic function indicators included postural hypotension, resting heart rate (HR), as well as HR response to and recovery from submaximal exercise testing (400m walk). Multivariable modeling adjusted for demographic/lifestyle factors, medication use and comorbid conditions. RESULTS: In fully adjusted models, poor motor nerve conduction velocity (<40m/s) was associated with greater odds of postural hypotension, (OR=1.6, 95% CI: 1.0-2.5), while poor motor amplitude (<1mV) was associated with 2.3beats/min (p=0.003) higher resting HR. No associations were observed between sensory nerve function or symptoms of peripheral neuropathy and indicators of cardiovascular autonomic function. CONCLUSIONS: Motor nerve function and indicators of cardiovascular autonomic function remained significantly related even after considering many potentially shared risk factors. Future studies should investigate common underlying processes for developing multiple PNS impairments in older adults.
BACKGROUND: Age-related peripheral nervous system (PNS) impairments are highly prevalent in older adults. Although sensorimotor and cardiovascular autonomic function have been shown to be related in persons with diabetes, the nature of the relationship in general community-dwelling older adult populations is unknown. METHODS: Health, Aging and Body Composition participants (n=2399, age=76.5±2.9years, 52% women, 38% black) underwent peripheral nerve testing at the 2000/01 clinic visit. Nerve conduction amplitude and velocity were measured at the peroneal motor nerve. Sensory nerve function was assessed with vibration detection threshold and monofilament (1.4-g/10-g) testing at the big toe. Symptoms of lower-extremity peripheral neuropathy were collected by self-report. Cardiovascular autonomic function indicators included postural hypotension, resting heart rate (HR), as well as HR response to and recovery from submaximal exercise testing (400m walk). Multivariable modeling adjusted for demographic/lifestyle factors, medication use and comorbid conditions. RESULTS: In fully adjusted models, poor motor nerve conduction velocity (<40m/s) was associated with greater odds of postural hypotension, (OR=1.6, 95% CI: 1.0-2.5), while poor motor amplitude (<1mV) was associated with 2.3beats/min (p=0.003) higher resting HR. No associations were observed between sensory nerve function or symptoms of peripheral neuropathy and indicators of cardiovascular autonomic function. CONCLUSIONS: Motor nerve function and indicators of cardiovascular autonomic function remained significantly related even after considering many potentially shared risk factors. Future studies should investigate common underlying processes for developing multiple PNS impairments in older adults.
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