cutaneous sensitivity, disability, functional limitation, touch-pressure, vibration perception



  1. Bear-Lehman, Jane PhD, OTR, FAOTA
  2. Albert, Steven M. PhD, MSc
  3. Burkhardt, Ann OTD, OTR/L


Clinical examination of cutaneous sensory response for touch-pressure and vibratory threshold perception is mostly conducted as part of neuropathy screening in diabetic clinics. Yet, declines in tactile thresholds in the skin have been reported as a feature of aging and may be important for understanding functional status more generally. The Sources of Independence in the Elderly study includes 361 Medicare beneficiaries in northern Manhattan, New York City, at an early point in the disablement process. Each participant was assessed for touch-pressure and vibration perception in the hands and feet. People with diabetes or dementia were excluded. Self-reports of difficulty in the ability to grasp objects and in balance were examined in light of hand and foot cutaneous sensitivity, respectively, adjusting for known correlates of functional limitation. Cutaneous sensitivity in the hand and foot was independently associated with reports of functional limitation in models that adjusted for performance tests of hand use and balance as well as other correlates. In the presence of declining hand dexterity or standing balance, better hand or foot sensitivity was associated with lower likelihood of functional limitation. Deficits in the ability to perceive sensory stimulation in the hands and feet are an independent source of functional limitation.