Ward, Rachel E
(2013)
Peripheral Nerve Decline Impacts Lower Extremity Muscle Function in Older Adults.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
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
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| 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: |
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
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| 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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