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Peripheral Nerve Decline Impacts Lower Extremity Muscle Function in Older Adults

Ward, Rachel E (2013) Peripheral Nerve Decline Impacts Lower Extremity Muscle Function in Older Adults. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

The prevalence of poor peripheral nerve function increases with age from approximately 8% at ages 40-49 to 35% after age 80 and likely contributes to declines in muscle strength, power, and mobility limitations. However, longitudinal evidence is lacking and the relationship between nerve function and muscle power has not been examined even at a cross-sectional level. This dissertation investigates the role of sensory and motor peripheral nerve function in muscle function decline and incident mobility limitation in older adults using data from two longitudinal cohort studies. Data from the Osteoporotic Fractures in Men Study (MrOS) show that poor motor and sensory nerve function are independently associated with poor muscle power and that light monofilament insensitivity is associated with greater decline in muscle power. Findings from the Health Aging and Body Composition (Health ABC) Study indicate that sensory and motor nerve function are predictive of subsequent strength and concurrent change in strength, although improvement in nerve function may not always lead to improvements in strength. We also found that sex modified the relationship between nerve function and strength, with motor and sensory nerve function being associated with strength in women and only sensory nerve function being associated with strength in men. Again using data from the Health ABC Study, we found that poor initial motor and sensory nerve function and sustained poor motor nerve function over seven years independently predicted incident mobility limitation. Understanding the role of neuromuscular parameters in the disablement process may help to identify multiple points of intervention. Our findings have important public health implications, suggesting a need for future work to examine early prevention of modifiable risk factors and secondary prevention to slow muscle function declines and prevent mobility limitation. Since our results persisted after adjustment for known risk factors for poor nerve function such as diabetes and vitamin B12 deficiency, novel risk factors should also be explored.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Ward, Rachel Erew42@pitt.eduREW42
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairStrotmeyer, Elsa Sstrotmeyere@edc.pitt.eduELSST21
Committee MemberNewman, Anne Banewman@pitt.eduANEWMAN
Committee MemberCauley, Jane AJCauley@edc.pitt.eduJCAULEY
Committee MemberBoudreau, Robert Mrob21@pitt.eduROB21
Committee MemberGoodpaster, Bret Hbgood@pitt.eduBGOOD
Committee MemberCaserotti, PaoloPCaserotti@health.sdu.dk
Date: 27 September 2013
Date Type: Publication
Defense Date: 18 June 2013
Approval Date: 27 September 2013
Submission Date: 3 June 2013
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 139
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: peripheral nerve function muscle power strength mobility limitation disability sensory nerve function motor nerve function muscle function diabetes longitudinal analysis
Date Deposited: 27 Sep 2013 16:13
Last Modified: 15 Nov 2016 14:13
URI: http://d-scholarship.pitt.edu/id/eprint/19117

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