Establishment of evaluation method of peripheral neuropathy and the detection of its risk factors in Japanese elderly people for the purpose of frailty prevention

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K01723
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Applied health science
• Research Institution: Wakayama Medical University
• Principal Investigator: Sasaki Hideyuki 和歌山県立医科大学, 医学部, 教授 (80205856)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 高齢者 / フレイル / 末梢神経障害 / 神経伝導速度 / 神経活動電位振幅 / 振動覚閾値 / 表皮内神経痛覚閾値 / 耐糖能

Outline of Final Research Achievements

Although peripheral neuropathy may be the cause of frailty, there has been no accurate diagnosis / evaluation method for peripheral neuropathy in the elderly. We examined the vibratory perception threshold, conduction velocity and amplitude of action potential of the sural nerve, and the pain thresholds of intraepithelial nerve in the participants of regional health check-up screening program. Then, we determined the normal limit value for each examination considering the age. In addition, we investigated the risk factors of peripheral neuropathy using the results of these tests and found that diabetes and smoking cessation are important for the prevention, and that high blood pressure and alcohol consumption also lead to the decrease in nerve function.
Furthermore, we have demonstrated that peripheral neuropathy is associated with muscle weakness, and its diagnosis has the potential to be useful for screening high-risk individuals with frailty.

Free Research Field

末梢神経学　糖尿病学

Academic Significance and Societal Importance of the Research Achievements

我が国において健康寿命の延伸は喫緊の課題であり、介護が必要な状態に陥る前のフレイルの時期に診断し、介入することが望まれる。本研究ではフレイルの要因のひとつと考えられる末梢神経障害を高齢者において診断できる基準値を策定し、臨床現場での診断を容易にすることができた。また、末梢神経障害予防に禁煙、糖尿病予防、高血圧予防、節酒といった具体的な対策を提示することができた。今後は定量的振動覚閾値測定やPOCT機による神経伝導検査を日常診療や健康診断に取り入れて、早期に末梢神経障害を診断し、生活・運動・食事指導を行うことにより、フレイルから要介護に至る症例を減少させることが重要である。