Vascular factors as predictors of polyneuropathy in a non-diabetic cohort of Italian elderly: the Italian longitudinal study on aging (ILSA)

Background and aims: Chronic polyneuropathy is a common
diagnosis with an estimated prevalence of 7% in the elderly population,
and it is a major predictor of poor motor function. Despite
intensive investigation, 10-40% of patients with polyneuropathy
referred to specialist centres, lack a causative diagnosis. We
prospectively examined whether vascular factors are related to an
increased incidence of Chronic Idiopathic Distal Symmetric Neuropathy
(CI-DSN).
Methods: The study population comprised 5,632 individuals of the
ILSA. Potential effect of vascular factors was estimated by regressing
CI-DSN on the occurrence of several vascular factors in a subcohort
of 2,512 non-diabetic individuals.Multivariate relative risks
of CI-DSN were estimated by Cox proportional hazards model.
RESULTS. After 3.8 years of follow-up, we documented 51 incident
CI-DSN cases.At univariate analyses, age, comorbidity, waist
circumference, leg length, peripheral artery disease (PAD), and
coronary hearth disease proved to significantly increased the risk
of developing CI-DSN. Entering these significant covariates into a
Cox regression model, only age (RR=1.08; 95%CI, 1.02 to 1.14),
leg length (RR=1.05; 95%CI, 1.01 to 1.1), and PAD (RR=2.75;
95%CI, 1.15 to 6.56) proved significant predictors of CI-DSN.
Conclusions: The presence at baseline of PAD is associated with a
two-fold increase in the risk of developing CI-DSN. Our data from
a population-based perspective strongly support the evidence that
the incidence of polyneuropathy in non-diabetic individuals is
associated with potentially modifiable vascular factors