Prevalence, Risk Factors and Consequences of Chronic Polyneuropathy : The Rotterdam Study

Polyneuropathy is a chronic disease characterized by symmetric tingling sensations, numbness and neuropathic pain in the hands and feet. There is a lack of knowledge about the prevalence and risk factors of this disease, especially on population level. Within the Rotterdam Study, a large population-based study, we employed an extensive polyneuropathy screening consisting of a symptom questionnaire, neurological examination and nerve conduction studies. With this screening we prospectively screened 1310 participants and found a definite polyneuropathy in 5.5% of persons above 45 years of age, and this percentage increased drastically with age. In 46% of persons with polyneuropathy, no established risk factor was present (chronic idiopathic axonal polyneuropathy), which highlights the need for further studies on risk factors for this disease. Aside from diabetes, which probably is the most important known risk factor for chronic polyneuropathy, we identified metabolic syndrome and especially (abdominal) obesity and dyslipidemia as potential risk factors for polyneuropathy. Importantly, these factors also associated with decreased peripheral nerve function in persons (yet) without signs or symptoms of polyneuropathy. This suggest that these factors have role in the pathophysiology of chronic axonal polyneuropathies, but longitudinal studies are required to confirm these associations. We also studied the effect of polyneuropathy on daily life and found that polyneuropathy associated with impairment in several basic activities of daily living, such as arising, dressing and grooming, eating and walking. Furthermore, persons with polyneuropathy have an increased risk of falling, and on the potential consequences of falling, such as head trauma and fractures.
To conclude, polyneuropathy is a very common, often idiopathic, disabling disorder. More research is necessary to elucidate the pathophysiology of this multifactorial disease.