CNR - Institute of Neuroscience CNR
Institute of Neuroscience


Epidemiology of Distal Symmetric Neuropathy in the Italian elderly

The quality of life in old age is intimately associated with one's ability to perform physical activities. Walking and balance are critical for maintenance of mobility, avoidance of disability in common activities and possibly for preservation of independence in the community. Recent studies demonstrated that Distal Symmetric Neuropathies (DSN) are strong determinants of reduced lower-extremity physical function and mobility in the elderly .The frequency and distribution of DSN in the community are still largely unknown. Moreover, DSN is a condition that does not necessarily lead to medical attention. Only population surveys could provide unbiased estimations of prevalence and incidence.


This investigation was part of the ILSA, a multicenter community-based study of prevalence, incidence and determinants of major age-associated conditions of the elderly. This study estimated prevalence and incidence of DSN in a well representative sample of the Italian elderly. The DSN-free cohort was identified within the overall ILSA sample (5632 individuals aged 65-84 years random selected from the population registers of eight Italian municipalities) using a cross-sectional study carried out in 1992 to 1993, which led to the detection of the prevalent cases of DSN (baseline survey). The ILSA cohort was followed for an average of 3 years. All the cohort individuals were contacted again during the second cross-sectional survey (follow-up survey) carried out in 1995 to 1996.

Each sampled individual was directly screened for every disease under investigation.

The ILSA: Study sample

5,632 free-dwelling and institutionalized individuals, aged 65-84, resident in 8 centers (urban, suburban, rural), randomly selected from the local anagraphic lists (equal allocation by sex and 5-year-age groups).


Selected results

Attrition of the sampled population from the Italian Longitudinal Study on Aging at each step of the two study surveys.


Prevalence of distal symmetrical neuropathy in the Italian Longitudinal Study on Aging cohort at baseline (1992), by age and gender.


Incidence of distal symmetrical neuropathy in the Italian Longitudinal Study on Aging cohort, by age and gender.



There are three major findings from this large population-based study:

  • the prevalence of DSN in the Italian elderly turned out to be higher than previously reported;
  • we could provide the first incidence data of DSN in the general elderly population;
  • DSN is an age-associated condition, but the frequency of diabetic DSN declines with age, coincident with an increase in non-diabetic cases.


  • 9363520 [Warning: check DB]
  • Maggi S, Zucchetto M, Grigoletto F, Baldereschi M, Candelise L, Scarpini E, Scarlato G, Amaducci L (1994) The Italian Longitudinal Study on Aging (ILSA): design and methods. Aging (Milano) 6:464-73.
  • Baldereschi M, Inzitari M, Di Carlo A, Farchi G, Scafato E, Inzitari D, (2007) Epidemiology of distal symmetrical neuropathies in the Italian elderly. Neurology 68:1460-7.
  • Noale M, Maggi S, Marzari C, Limongi F, Gallina P, Bianchi D, Crepaldi G, (2006) Components of the metabolic syndrome and incidence of diabetes in elderly Italians: the Italian Longitudinal Study on Aging. Atherosclerosis 187:385-92.


1991 - 1998: The ILSA was supported by the Italian National Research Council with annual grants to each research unit


  • S. Maggi, Italian National Research Council, Padua, Italy.
  • G. Scarlato, MD, L. Candelise, MD, E. Scarpini, University of Milan, Italy.
  • P. Carbonin, Università Cattolica del Sacro Cuore, Rome, Italy.
  • G. Farchi, MSc, E. Scafato, Istituto Superiore di Sanità, Rome, Italy.
  • F. Grigoletto, E. Perissinotto, L. Battistin, M. Bressan, G. Enzi, G. Bortolan, University of Padua, Italy.
  • C. Loeb, Italian National Research Council, Genoa, Italy.
  • C. Gandolfo, University of Genoa, Italy.
  • N. Canal, M. Franceschi, San Raffaele Institute, Milan, Italy.
  • A. Ghetti, R. Vergassola, Health Area 10, Florence, Italy.
  • L. Amaducci, D. Inzitari, University of Florence, Italy.
  • S. Bonaiuto, F. Fini, A. Vesprini, G. Cruciani, INRCA Fermo, Italy.
  • A. Capurso, P. Livrea, V. Lepore, University of Bari, Italy.
  • L. Motta, G. Carnazzo, P. Bentivegna, University of Catania, Italy.
  • F. Rengo, F. Covelluzzi, University of Naples, Italy.
  • M. Inzitari, Socio-Sanitary Hospital Pere Virgili and Institute on Aging of the Autonomous University of Barcelona, Spain.


PI photo

Marzia Baldareschi

Contact information

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Participating staff