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