A condition affecting the arteries of the legs, called lower extremity peripheral artery disease, leads to significant disability among the elderly and is underdiagnosed by doctors, suggest the results of a study.

Peripheral artery disease, or PAD, causes few symptoms in some people but can affect functioning and often precedes more severe and life-threatening disease in the elderly.

"It is important to recognize this disease because it is associated with impaired functioning, and it is associated with an increased risk of death from cardiovascular disease," says the study's lead author, Mary McGrae McDermott, M.D., of the departments of medicine and preventive medicine at Northwestern University Medical School, in Chicago.

PAD of the legs involves a narrowing of the leg arteries, usually resulting from the fatty buildup on artery walls known as atherosclerosis. Symptoms of the condition include aching, cramping or tired leg muscles during physical activity; sometimes few or no symptoms are present.

McDermott and colleagues compared three groups of study participants, all aged 55 or older. The 143 participants in Group One had been diagnosed with PAD; the 34 participants in Group Two had undiagnosed PAD, which the researchers diagnosed through a test of leg blood flow, and the 113 participants in Group Three did not have PAD. The researchers tested participants' walking speed, asked them how well they navigated around their homes and neighborhoods and measured their leg function.

The symptoms experienced by undiagnosed PAD group weren't as severe as those experienced by those with diagnosed PAD, which probably explained why the former had never been diagnosed with PAD, the researchers found. Those with undiagnosed disease had lower scores on physical functioning than those in the healthy group, but they were no more likely to report leg pain or weakness.

The results are published in the June issue of the Journal of General Internal Medicine.

These findings suggest many cases of PAD go undiagnosed due to lack of symptoms. The best way to identify PAD is through a test of blood flow called the ankle brachial index test.

"Our data support screening men and women aged 55 and above in general medical practices for PAD with the ankle brachial index," said the researchers, who found that 14 percent of 239 patients in their practice had undiagnosed PAD.

Treating PAD involves treating high blood pressure and cholesterol levels, weight management, smoking cessation and physical exercise, which can improve muscle function and increase blood flow to the leg muscles.

"Further study is needed to identify how to increase ankle brachial index screening and recognition of PAD in general medical practices," McDermott concluded.

This study was supported in part by the National Heart Lung and Blood Institute and the National Institutes of Health.

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The Journal of General Internal Medicine, a monthly peer-reviewed journal of the Society of General Internal Medicine, publishes original articles on research and education in primary care. For information about the journal, contact Renee F. Wilson at (410) 955-9868.