Age-related changes in cutaneous sensation in the healthy human hand
Cutaneous sensation deteriorates with age. It is not known if this change is consistent over the entire hand or if sensation is affected by changes in skin mechanics. Cutaneous perceptual thresholds were tested at eight sites in the glabrous skin and two in the hairy skin of both hands in 70 subjects (20–88 years), five male and five female per decade, using calibrated von Frey filaments, two-point discrimination, and texture discrimination. Venous occlusion at the wrist (40 ± 10 mmHg) and moisturizer were used to alter skin mechanics. Cutaneous thresholds increased significantly with age (p < 0.001); von Frey thresholds were 0.04 g [0.02–0.07] (median and interquartile range) in the 20s and 0.16 g [0.04–0.4] in the 80s, with differences between hands for older females (p = 0.044) but not males. The pattern of changes in cutaneous sensation varied according to the site tested with smaller changes on the fingers compared to the palm. Two-point discrimination deteriorated with age (p = 0.046), but with no interaction between sex, handedness, or changes in skin mechanics. There were no significant differences for texture discrimination. Changes in skin mechanics improved cutaneous thresholds in the oldest males after moisturizing (p = 0.001) but not otherwise. These results emphasize the complex pattern of age-related deterioration in cutaneous sensation with differences between sexes, the hands, sites on the hand, and the mode of testing. As the index fingertip is not a sensitive indicator of sensory decline, the minimum assessment of age-related changes in cutaneous sensation should include both hands, and sites on the palm.
KeywordsPerceptual thresholds von Frey filaments Two-point discrimination Texture Handedness
This work was supported by the National Health and Medical Research Council of Australia; the New South Wales Office of Science and Medical Research; and the University of New South Wales.
- Bear-Lehman J, Miller PA, Adler M, Buonocore JM, Coles N, Kneafsey BS, Katz-Sillman F, Sherman-Amsel H (2003) An exploration of hand strength and sensation in community elders. Top Geriatr Rehabil 19:127–136Google Scholar
- Bell-Krotoski J (1995) Sensibility testing: current concepts. In: Hunter JM, Mackin EJ, Callahan AD (eds) Rehabilitation of the hand: Surgery and therapy, 4th edn. Mosby, St. LouisGoogle Scholar
- Cauna N (1965) The effects of aging on the receptors organs of the human dermis. In: Montagna W (ed) Advances in Biology of Skin, vol VI, Aging. Pergamon Press, New York, pp 63–96Google Scholar
- Rexed B (1944) Fibre size in the peripheral nervous system of adults and old persons. Acta Physiol Scand 19:164–186Google Scholar
- Weber EH (1834) The sense of touch. Academic Press for Experimental Psychology Society, London, trans: Ross HE, Murray DJ, 1978Google Scholar
- Wood Jones F (1920) The principles of anatomy as seen in the hand. Churchill, LondonGoogle Scholar