Sensorimotor impairments, postural instability, and risk of falling in older adults with diabetic peripheral neuropathy

Wettasinghe, Asha (Department of Allied Health Sciences, University of Colombo) ; Dissanayake, Dilshani (Department of Physiology, University of Colombo) ; Allet, Lara (Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland ; Department of Community Medicine, University Hospitals and University of Geneva) ; Katulanda, Prasad (Department of Clinical Medicine, University of Colombo) ; Lord, Stephen R. (Neuroscience Research Australia, UNSW)

Background : Older adults with type 2 diabetes mellitus (DM) have high incidence of falls. The aim of this study was to compare sensorimotor functions, balance, mobility, fear of falling, and fall history in older people with DM (with and without neuropathy) and non-diabetic healthy controls. Methods : We enrolled 153 participants aged 50–70 years: 51 people with diabetic peripheral neuropathy (D-PN), 52 with diabetes without neuropathy (D-noPN), and 50 healthy controls (HC). Participants completed a fear of falling assessment and detailed test battery comprising sensorimotor functions, lower limb strength, contrast vision, reaction time, balance, and mobility from which a composite physiological fall risk score (PFRS) was derived. In addition, a fall history of the past 3 months was recorded. Results :Post hoc comparisons of ANOVA test revealed the D-PN had significant deficits than the other two groups in tests of lower limb sensation, knee extension strength, reaction time, postural sway, one leg standing, sit-to-stand and the timed up and go test. The D-PN had the highest fear of falling (30.18 ± 6.75) and the highest PFRS (1.68 ± 1.13). PFRS for the D-noPN (0.74 ± 0.80) was intermediate between HC (0.49 ± 0.96) and DP-N groups. Thirty-four D-PN participants (66.7%), 19 D-noPN participants (36.5%), and 7 HC (14.0%) reported one or more falls in the past 3 months (Chi2 test for trend = 28.1, df = 2, p < 0.001). Conclusions : Older people with diabetic neuropathy have impaired sensorimotor function, balance, mobility, and associated increased fear of falling and fall rates. This population may benefit from fall risk assessments involving the above measures, and subsequent interventions targeted to deficits amenable to correction.


Keywords:
Article Type:
scientifique
Faculty:
Santé
School:
HEdS - Genève
Institute:
Aucun institut
Date:
2020-05
Pagination:
8 p.
Published in:
International journal of diabetes in developing countries
Numeration (vol. no.):
2020, vol. 40, pp. 547-554
DOI:
ISSN:
0973-3930
Appears in Collection:

Note: The file is under embargo until: 2021-06-01


 Record created 2020-06-29, last modified 2021-03-01

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