Causes of neuropathy in the elderly: A retrospective study with 785 patients

PurposeNeuropathies are common in the elderly. The main aim of the study was to determine the most frequent causes of neuropathy in individuals more than 65-years-old, but also to determine their principle electrophysiological characteristics and the potential differences in the etiologies of the neuropathies as a function of age.MethodsWe conducted a retrospective study of 785 patients (500 men and 285 women) over 65 years of age (examined in the Department of Clinical Neurophysiology of the CHU Pitié-Salpêtrière of Paris for suspicion of neuropathy) over a period of eight years.ResultsWe observed 27 patients (3.4%) with a hereditary neuropathy; the 758 other patients had an acquired neuropathy of which 278 were idiopathic (35.4%). We found that 93.7% of patients presented axonal neuropathies, against only 6.2% of demyelinating neuropathy, with no significant statistical difference related to age. The first disease causing neuropathy in the elderly was diabetes (18.8%). Other causes were immune disorders (7.9%), toxic causes (7.4%), and inflammatory neuropathies (6%); other causes were < 3.5%.ConclusionIn our large group of patients, idiopathic neuropathies were the most common main cause of neuropathy in the elderly, the second being diabetes. However, idiopathic neuropathies seem to be particularly high in comparison with that observed in younger people. This observation could in part be explained by the aging of the peripheral nervous system (but also probably by a selection bias due to the recruitment of patients in the Department of Clinical Neurophysiology).