Hanewinckel Rens, Drenthen Judith, van Oijen Marieke, Hofman Albert, van Doorn Pieter A, Ikram M Arfan
From the Departments of Epidemiology (R.H., A.H., M.A.I.), Neurology (R.H., J.D., M.v.O., P.A.v.D.), and Clinical Neurophysiology (J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands; and Department of Epidemiology (A.H.), Harvard T.H. Chan School of Public Health, Boston, MA.
Neurology. 2016 Nov 1;87(18):1892-1898. doi: 10.1212/WNL.0000000000003293. Epub 2016 Sep 28.
To determine the prevalence of chronic polyneuropathy in an unselected community-dwelling population of middle-aged and elderly people.
The current study was embedded in the prospective, population-based Rotterdam Study. Between June 2013 and October 2015, 1,310 participants (mean age 70 years, 55% female) were screened for the presence of polyneuropathy. This screening consisted of a questionnaire, neurologic examination, and nerve conduction studies. Polyneuropathy was diagnosed by a consensus panel that categorized participants into no, possible, probable, or definite polyneuropathy, depending on the level of abnormality of the screening. Medical records were scrutinized to evaluate whether the disorder was diagnosed before and laboratory investigations were performed to determine the presence of associated risk factors.
Prevalence of definite polyneuropathy was 5.5% (95% confidence interval 4.4-6.9), age-standardized to the population of the Netherlands 4.0% (3.1-5.3). Prevalence was higher in male participants (6.7% compared to 4.5%) and increased with age. When combining probable and definite polyneuropathy, age-standardized prevalence was 9.4% (7.9-11.1). Almost half of the polyneuropathies (49%) were newly diagnosed. The majority of polyneuropathies were idiopathic (46%). Diabetes, present in 31% of participants with polyneuropathy, was the most commonly found risk factor.
Prevalence of polyneuropathy in the general middle-aged and elderly population is at least 4%, and increases with age. Almost half of the cases were newly diagnosed, indicating that the presence of polyneuropathy is underreported or underdiagnosed. Currently, almost half of the polyneuropathies are idiopathic. Future prospective cohort studies should focus on identifying new determinants of polyneuropathy.
确定未经过挑选的社区中老年人群中慢性多发性神经病的患病率。
本研究纳入了基于人群的前瞻性鹿特丹研究。2013年6月至2015年10月期间,对1310名参与者(平均年龄70岁,55%为女性)进行了多发性神经病筛查。该筛查包括问卷调查、神经系统检查和神经传导研究。一个共识小组根据筛查异常程度将参与者分为无、可能、很可能或确诊的多发性神经病,以此诊断多发性神经病。仔细查阅病历以评估该疾病之前是否已被诊断,并进行实验室检查以确定相关危险因素的存在情况。
确诊多发性神经病的患病率为5.5%(95%置信区间4.4 - 6.9),经年龄标准化后,荷兰人群的患病率为4.0%(3.1 - 5.3)。男性参与者的患病率更高(6.7%,而女性为4.5%),且随年龄增长而增加。若将很可能和确诊的多发性神经病合并计算,经年龄标准化后的患病率为9.4%(7.9 - 11.1)。几乎一半的多发性神经病(49%)是新诊断出来的。大多数多发性神经病是特发性的(46%)。糖尿病在31%的多发性神经病参与者中存在,是最常见的危险因素。
一般中老年人群中多发性神经病的患病率至少为4%,且随年龄增长而增加。几乎一半的病例是新诊断出来的,这表明多发性神经病的存在情况报告不足或诊断不足。目前,几乎一半的多发性神经病是特发性的。未来的前瞻性队列研究应侧重于确定多发性神经病的新决定因素。