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多发性神经病与日常活动受损、步态变差以及跌倒相关损伤有关。

Polyneuropathy relates to impairment in daily activities, worse gait, and fall-related injuries.

作者信息

Hanewinckel Rens, Drenthen Judith, Verlinden Vincentius J A, Darweesh Sirwan K L, van der Geest Jos N, Hofman Albert, van Doorn Pieter A, Ikram M Arfan

机构信息

From the Departments of Epidemiology (R.H., V.J.A.V., S.K.L.D., A.H., M.A.I.), Neurology (R.H., J.D., P.A.v.D.), Neuroscience (J.D., J.N.v.d.G.), and Clinical Neurophysiology (J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands; and Department of Epidemiology (S.K.L.D., A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.

出版信息

Neurology. 2017 Jul 4;89(1):76-83. doi: 10.1212/WNL.0000000000004067. Epub 2017 May 31.

Abstract

OBJECTIVE

To extensively investigate the association of chronic polyneuropathy with basic and instrumental activities of daily living (BADL and IADL), falls, and gait.

METHODS

A total of 1,445 participants of the population-based Rotterdam Study (mean age 71 years, 54% women) underwent a polyneuropathy screening involving a symptom questionnaire, neurologic examination, and nerve conduction studies. Screening yielded 4 groups: no, possible, probable, and definite polyneuropathy. Participants were interviewed about BADL (Stanford Health Assessment questionnaire), IADL (Instrumental Activities of Daily Living scale), and frequency of falling in the previous year. In a random subset of 977 participants, gait was assessed with an electronic walkway. Associations of polyneuropathy with BADL and IADL were analyzed continuously with linear regression and dichotomously with logistic regression. History of falling was evaluated with logistic regression, and gait changes were evaluated with linear regression.

RESULTS

Participants with definite polyneuropathy had more difficulty in performing BADL and IADL than participants without polyneuropathy. Polyneuropathy related to worse scores of all BADL components (especially walking) and 3 IADL components (housekeeping, traveling, and shopping). Participants with definite polyneuropathy were more likely to fall, and these falls more often resulted in injury. Participants with polyneuropathy had worse gait parameters on the walkway, including lower walking speed and cadence, and more errors in tandem walking.

CONCLUSIONS

Chronic polyneuropathy strongly associates with impairment in the ability to perform daily activities and relates to worse gait and an increased history of falling.

摘要

目的

广泛研究慢性多发性神经病与基本日常生活活动(BADL)和工具性日常生活活动(IADL)、跌倒及步态之间的关联。

方法

基于人群的鹿特丹研究中的1445名参与者(平均年龄71岁,54%为女性)接受了多发性神经病筛查,包括症状问卷、神经学检查和神经传导研究。筛查产生了4组:无、可能、很可能和确诊的多发性神经病。就BADL(斯坦福健康评估问卷)、IADL(工具性日常生活活动量表)以及上一年的跌倒频率对参与者进行了访谈。在977名参与者的随机子集中,使用电子步道评估步态。采用线性回归连续分析多发性神经病与BADL和IADL之间的关联,采用逻辑回归进行二分法分析。采用逻辑回归评估跌倒史,采用线性回归评估步态变化。

结果

确诊为多发性神经病的参与者在进行BADL和IADL时比没有多发性神经病的参与者有更多困难。多发性神经病与所有BADL成分(尤其是步行)以及3种IADL成分(家务、出行和购物)的较差得分相关。确诊为多发性神经病的参与者更有可能跌倒,且这些跌倒更常导致受伤。患有多发性神经病的参与者在步道上的步态参数更差,包括步行速度和步频更低,以及在串联步行时出现更多失误。

结论

慢性多发性神经病与日常活动能力受损密切相关,并与较差的步态和增加的跌倒史有关。

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