Peripheral neuropathy in young-old and old-old patients

Diabetes is said to account for most cases of neuropathy in the elderly. We reviewed records of 223 young-old (65-79 years) and 77 old-old (greater th an or equal to 80 years) patients referred for evaluation of neuropathic sy mptoms over a 9-year period. We prospectively validated our findings in 102 consecutive elderly (77 young-old) patients receiving intensive evaluation for neuropathy. Diabetes was the most common cause of neuropathy (41%), bu t was less common in the old-old (25% versus 46%, P < 0.001). Idiopathic ne uropathies were more common in the old-old (39% versus 9%, P < 0.001). Alco holic and nutritional neuropathies were uncommon in the old-old. Electrophy siological studies showed that most patients had an axonal type of neuropat hy. Sural and peroneal response amplitudes were poorly correlated with age. We obtained similar results in our prospective study. The distribution of causes of neuropathies in young-old and old-old patients, in a hospital-bas ed sample, is age-related. Future studies need to include the old-old to be tter understand the nature of neuropathy in the elderly. (C) 2001 John Wile y & Sons, Inc.