Original article
Peripheral Nerve Function and Lower Extremity Muscle Power in Older Men

Presented to the Gerontological Society of America, November 19, 2011, Boston, MA.
https://doi.org/10.1016/j.apmr.2013.11.018Get rights and content

Abstract

Objective

To assess whether sensorimotor peripheral nerve function is associated with muscle power in community-dwelling older men.

Design

Longitudinal cohort study with 2.3±0.3 years of follow-up.

Setting

One clinical site.

Participants

Participants (n=372; mean age ± SD, 77.2±5.1y; 99.5% white; body mass index, 27.9±3.7kg/m2; power, 1.88±0.6W/kg) at 1 site of the Osteoporotic Fractures in Men Study (N=5994).

Interventions

Not applicable.

Main Outcome Measures

A nerve function ancillary study was performed 4.6±0.4 years after baseline. Muscle power was measured using a power rig. Peroneal motor nerve conduction amplitude, distal motor latency, and mean f-wave latency were measured. Sensory nerve function was assessed using 10-g and 1.4-g monofilaments and sural sensory nerve conduction amplitude and distal latency. Peripheral neuropathy symptoms at the leg and feet were assessed by self-report.

Results

After adjustments for age, height, and total body lean and fat mass, 1 SD lower motor (β=−.07, P<.05) and sensory amplitude (β=−.09, P<.05) and 1.4-g (β=−.11, P<.05) and 10-g monofilament insensitivity (β=−.17, P<.05) were associated with lower muscle power/kg. Compared with the effect of age on muscle power (β per year, −.05; P<.001), this was equivalent to aging 1.4 years for motor amplitude, 1.8 years for sensory amplitude, 2.2 years for 1.4-g monofilament detection, and 3.4 years for 10-g detection. Baseline 1.4-g monofilament detection predicted a greater decline in muscle power/kg. Short-term change in nerve function was not associated with concurrent short-term change in muscle power/kg.

Conclusions

Worse sensory and motor nerve function were associated with lower muscle power/kg and are likely important for impaired muscle function in older men. Monofilament sensitivity was associated with a greater decline in muscle power/kg, and screening may identify an early risk for muscle function decline in late life, which has implications for disability.

Section snippets

Study population

We used data from a nerve function ancillary study in which 372 participants had nerve function and power measured during the first visit, and 241 participants had these repeated during a second visit. The ancillary study was performed at the Monongahela Valley site 4.6±0.4 years after the 2000 to 2002 baseline visit. The second visit occurred 2.3±0.3 years later. This ancillary study was part of the Osteoporotic Fractures in Men Study, which is a cohort of community-dwelling ambulatory men

Results

Participant characteristics were compared across muscle power tertiles (table 1). Those in the lowest power tertile were older and shorter; had a higher BMI, greater fat mass, and lower lean mass; and were more likely to have a history of hypertension and worse Teng Modified Mini-Mental State Exam scores. Alcohol consumption frequency (mean, 2.6±1.3 drinks/wk), current smoking status (2.7%), and history of stroke (4.6%), congestive heart failure (7.3%), myocardial infarction (17.7%),

Discussion

Although muscle power is known to be dependent on both the nervous and musculoskeletal systems, previous research has not evaluated peripheral nerve function measures commonly used in clinical practice and neurologic studies. Studies4, 13 have indicated that muscle power declines at an even faster rate with age than strength, and our findings show that the potential effects of peripheral nerve function are 1.5 to 3.5 times the effect of 1 year of age. This finding has particularly important

Conclusions

We showed that sensory and motor nerve function are independently associated with muscle power, which is associated with poor outcomes in older adults, such as falls,3 impaired mobility,4, 5, 6, 7, 8, 9, 10, 11, 12 and disability.2, 50 Future work should investigate whether there is a direct relationship between poor nerve function and these poor health outcomes. Since monofilament insensitivity was predictive of greater muscle power decline, future studies should also test whether simple

Suppliers

  • a.

    NeuroMetrix, Inc, 62 4th Ave, Waltham, MA 02451.

  • b.

    University of Nottingham, Medical Faculty Workshops, Queen's Medical Centre, Nottingham, NG7 2UH, UK.

  • c.

    Hologic, Inc, 35 Crosby Dr, Bedford, MA 01730.

  • d.

    Stratec Medizintechnik GmbH, Durlacher Str. 35, 75172 Pforzheim, Germany.

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    The Osteoporotic Fractures in Men Study is supported by the following institutes of the National Institutes of Health: the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute on Aging, the National Center for Research Resources, and the National Institutes of Health Roadmap for Medical Research (grant nos. U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01-AG027810, UL1 RR024140).

    No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.

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