Original research| Volume 97, ISSUE 1, P45-52, January 2016

Sensorimotor Peripheral Nerve Function and the Longitudinal Relationship With Endurance Walking in the Health, Aging and Body Composition Study

Published:September 03, 2015DOI:



      To determine whether lower extremity sensorimotor peripheral nerve deficits are associated with reduced walking endurance in older adults.


      Prospective cohort study with 6 years of follow-up.


      Two university research clinics.


      Community-dwelling older adults enrolled in the Health, Aging and Body Composition Study from the 2000–2001 annual clinical examination (N=2393; mean age ± SD, 76.5±2.9y; 48.2% men; 38.2% black) and a subset with longitudinal data (n=1178).


      Not applicable.

      Main Outcome Measures

      Participants underwent peripheral nerve function examination in 2000–2001, including peroneal motor nerve conduction amplitude and velocity, vibration perception threshold, and monofilament testing. Symptoms of lower extremity peripheral neuropathy included numbness or tingling and sudden stabbing, burning, pain, or aches in the feet or legs. The Long Distance Corridor Walk (LDCW) (400m) was administered in 2000–2001 and every 2 years afterward for 6 years to assess endurance walking performance over time.


      In separate, fully adjusted linear mixed models, poor vibration threshold (>130μm), 10-g and 1.4-g monofilament insensitivity were each associated with a slower 400-m walk completion time (16.0s, 14.4s, and 6.9s slower, respectively; P<.05 for each). Poor motor amplitude (<1mV), poor vibration perception threshold, and 10-g monofilament insensitivity were related to greater slowing per year (4.7, 4.2, and 3.8 additional seconds per year, respectively; P<.05), although poor motor amplitude was not associated with initial completion time.


      Poorer sensorimotor peripheral nerve function is related to slower endurance walking and greater slowing longitudinally. Interventions to reduce the burden of sensorimotor peripheral nerve function impairments should be considered to help older adults maintain walking endurance—a critical component for remaining independent in the community.


      List of abbreviations:

      Health ABC (Health, Aging and Body Composition), LDCW (Long Distance Corridor Walk)
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        • Gregg E.W.
        • Sorlie P.
        • Pulose-Ram R.
        • et al.
        Prevalence of lower-extremity disease in the U.S. adult population 40+ years of age with and without diabetes.
        Diabetes Care. 2004; 27: 1591-1597
        • Baldereschi M.
        • Inzitari M.
        • Di Carlo A.
        • Farchi G.
        • Scafato E.
        • Inzitari D.
        Epidemiology of distal symmetrical neuropathies in the Italian elderly.
        Neurology. 2007; 68: 1460-1467
        • Ward R.E.
        • Boudreau R.M.
        • Caserotti P.
        • et al.
        Sensory and motor peripheral nerve function and incident mobility disability.
        J Am Geriatr Soc. 2014; 62: 2273-2279
        • Strotmeyer E.S.
        • De Rekeneire N.
        • Schwartz A.
        • et al.
        The relationship of reduced peripheral nerve function and diabetes with physical performance in older white and black adults.
        Diabetes Care. 2008; 31: 1767-1772
        • Cimbiz A.
        • Cakir O.
        Evaluation of balance and physical fitness in diabetic neuropathic patients.
        J Diabet Complications. 2005; 19: 160-164
        • Resnick H.E.
        • Stansberry K.
        • Harris T.
        • et al.
        Diabetes, peripheral neuropathy, and old age disability.
        Muscle Nerve. 2002; 25: 43-50
        • Resnick H.
        • Vinik A.
        • Schwartz A.V.
        • et al.
        Independent effects of peripheral nerve dysfunction on lower-extremity physical function in old age: the Women's Health and Aging Study.
        Diabetes Care. 2000; 23: 1642-1647
        • Strotmeyer E.S.
        • de Rekeneire N.
        • Schwartz A.V.
        • et al.
        Sensory and motor peripheral nerve function and lower-extremity quadriceps strength: the Health, Aging and Body Composition Study.
        J Am Geriatr Soc. 2009; 57: 2004-2010
        • Ward R.E.
        • Boudreau R.M.
        • Caserotti P.
        • et al.
        Sensory and motor peripheral nerve function and longitudinal changes in quadriceps strength.
        J Gerontol A Biol Sci Med Sci. 2015; 70: 464-470
        • Richardson J.
        • Ching C.
        • Hurvitz E.
        The relationship between electromyographically documented peripheral neuropathy and falls.
        J Am Geriatr Soc. 1992; 40: 1008-1012
        • Schwartz A.
        • Vittinghoff E.
        • Sellmeyer D.
        • et al.
        Diabetes-related complications, glycemic control, and falls in older adults.
        Diabetes Care. 2008; 31: 391-396
        • Ferrucci L.
        • Bandinelli S.
        • Cavazzini C.
        • et al.
        Neurological examination findings to predict limitations in mobility and falls in older persons without a history of neurological disease.
        Am J Med. 2004; 116: 807-815
        • Lalli P.
        • Chan A.
        • Garven A.
        • et al.
        Increased gait variability in diabetes mellitus patients with neuropathic pain.
        J Diabetes Complications. 2013; 27: 248-254
        • Mueller M.
        • Minor S.
        • Sahrmann S.
        • Schaaf J.
        • Strube M.
        Differences in the gait characteristics of patients with diabetes and peripheral neuropathy compared with age-matched controls.
        Phys Ther. 1994; 74: 299-308
        • Katoulis E.
        • Ebdo-Parry M.
        • Lanshammar H.
        • Vileikyte L.
        • Krlkarni J.
        • Boulton A.
        Gait abnormalities in diabetic neuropathy.
        Diabetes Care. 1997; 20: 1904-1907
        • Raspovic A.
        Gait characteristics of people with diabetes-related peripheral neuropathy, with and without a history of ulceration.
        Gait Posture. 2013; 38: 723-728
        • Brach J.
        • Talkowiski J.
        • Strotmeyer E.
        • Newman A.
        Diabetes mellitus and gait dysfunction: possible explanitory factors.
        Phys Ther. 2008; 88: 1365-1374
        • Deschamps K.
        • Matricali G.A.
        • Roosen P.
        • et al.
        Comparison of foot segmental mobility and coupling during gait between patients with diabetes mellitus with and without neuropathy and adults without diabetes.
        Clin Biomech. 2013; 28: 813-819
        • Menz H.
        • Lord S.
        • St George R.
        • Fitzpatrick R.
        Walking stability and sensorimotor function in older people with diabetic peripheral neuropathy.
        Arch Phys Med Rehabil. 2004; 85: 245-252
        • Özdirenç M.
        • Biberoğlu S.
        • Özcan A.
        Evaluation of physical fitness in patients with type 2 diabetes mellitus.
        Diabetes Res Clin Pract. 2003; 60: 171-176
        • Kanade R.V.
        • Deursen R.W.
        • Harding K.
        • Price P.
        Walking performance in people with diabetic neuropathy: benefits and threats.
        Diabetologia. 2006; 49: 1747-1754
        • McDermott M.
        • Guralnik J.
        • Albay M.
        • Bandinelli S.
        • Miniati B.
        • Ferrucci L.
        Impairments of muscles and nerves associated with peripheral arterial disease and their relationship with lower extremity functioning: the InCHIANTI Study.
        J Am Geriatr Soc. 2004; 52: 405-410
        • Tesfaye S.
        • Boulton A.
        • Dyck P.
        • et al.
        Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments.
        Diabetes Care. 2010; 33: 2285-2293
        • Simonsick E.
        • Newman A.
        • Nevitt M.
        • et al.
        Measuring higher level physical function in well-functioning older adults.
        J Gerontol A Biol Sci Med Sci. 2001; : M644-M649
        • Ward R.E.
        • Boudreau R.M.
        • Vinik A.I.
        • et al.
        Reproducibility of peroneal motor nerve conduction measurement in older adults.
        Clin Neurophysiol. 2013; 124: 603-609
        • Maser R.E.
        • Nielsen V.K.
        • Dorman J.S.
        • Drash A.L.
        • Becker D.J.
        • Orchard T.J.
        Measuring subclinical neuropathy: does it relate to clinical neuropathy? Pittsburgh Epidemiology of Diabetes Complications Study-V.
        J Diabet Complications. 1991; 5: 6-12
        • Simonsick E.
        • Fan E.
        • Fleg J.
        Estimating cardiorespiratory fitness in well-functioning older adults: treadmill validation of the Long Distance Corridor Walk.
        J Am Geriatr Soc. 2005; : 127-132
        • Simonsick E.
        • Montgomery P.
        • Newman A.
        • Bauer D.
        • Harris T.
        Measuring fitness in healthy older adults: the Health ABC Long Distance Corridor Walk.
        J Am Geriatr Soc. 2001; 49: 1544-1548
        • Ainsworth B.
        • Haskell W.
        • Leon A.
        • et al.
        Compendium of physical activities: classification of energy costs of human physical activities.
        Med Sci Sports Exerc. 1993; 25: 71-80
        • American Diabetes Association
        Diagnosis and classification of diabetes mellitus.
        Diabetes Care. 2013; 36: S67-74
        • Aboyans V.
        • Criqui M.
        • Abraham P.
        • et al.
        Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association.
        Circulation. 2012; 126: 2890-2909
        • Leishear K.
        • Boudreau R.M.
        • Studenski S.A.
        • et al.
        Relationship between vitamin B12 and sensory and motor peripheral nerve function in older adults.
        J Am Geriatr Soc. 2012; 60: 1057-1063
        • Shlipak M.
        • Wassel Fyr C.
        • Chertow G.
        • et al.
        Cystatin C and mortality risk in the elderly: the Health, Aging, and Body Composition Study.
        J Am Soc Nephrol. 2006; 17: 254-261
        • Wechsler D.
        Wechsler Adult Intelligence Scale–Revised.
        Psychological Corp, San Antonio1981
        • Teng E.
        • Chui H.
        The Modified Mini-Mental State (3MS) Examination.
        J Clin Psychiatry. 1987; 48: 314-318
        • Radloff L.
        The CES-D Scale: a self-report depression scale for research in the general population.
        Appl Psychol Meas. 1977; 1: 385-401
        • Buchman A.S.
        • Wilson R.S.
        • Leurgans S.
        • Bennett D.A.
        Vibratory thresholds and mobility in older persons.
        Muscle Nerve. 2009; 39: 754-760
        • Zurales K.
        • DeMott T.K.
        • Kim H.
        • Allet L.
        • Ashton-Miller J.A.
        • Richardson J.K.
        Gait efficiency on an uneven surface is associated with falls and injury in older subjects with a spectrum of lower limb neuromuscular function: a prospective study.
        Am J Phys Med Rehabil. 2015 Jun 5; ([Epub ahead of print])
        • Tinetti M.
        • Speechley M.
        • Ginter S.
        Risk factors for falls among elderly persons living in the community.
        N Engl J Med. 1988; 319: 1701-1707
        • Hausdorff J.M.
        • Edelberg H.K.
        • Mitchell S.
        • Goldberger A.
        • Wei J.
        Increased gait unsteadiness in community-dwelling elderly fallers.
        Arch Phys Med Rehabil. 1997; 78: 278-283
        • Hausdorff J.M.
        • Rios D.A.
        • Edelberg H.K.
        Gait variability and fall risk in community-living older adults: a 1-year prospective study.
        Arch Phys Med Rehabil. 2001; 82: 1050-1056
        • Pahor M.
        • Guralnik J.M.
        • Ambrosius W.T.
        • et al.
        Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial.
        JAMA. 2014; 311: 2387-2396
        • Strotmeyer E.
        • Arnold A.
        • Boudreau R.
        • et al.
        Long-term retention of older adults in the Cardiovascular Health Study: implications for studies of the oldest old.
        J Am Geriatr Soc. 2010; 58: 696-701