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Comparison of Neurologic Changes in 'Successfully Aging' Persons vs the Total Aging Population

Comparison of Neurologic Changes in 'Successfully Aging' Persons vs the Total Aging Population Abstract Objective: To determine age-related changes in neurologic function in the general population. Design: To administer a neurologic examination to participants in such a way that it is possible to calculate the proportion of elderly persons in the population with each abnormal finding and the proportion of persons with each finding but without evidence of the medical and neurologic diseases likely to produce neurologic abnormalities (eg, stroke and diabetes). Setting: Individuals were selected from a communitydwelling population. Participants: A stratified random sample of 467 persons aged 65 years and older were evaluated. Results: Many neurologic abnormalities are increasingly common with advancing age and are present in a substantial portion of the elderly population. The prevalence of abnormal neurologic findings not attributable to disease, however, is substantially lower, typically one half to one third the total prevalence. Moreover, the increase with age in the prevalence of abnormal neurologic findings not attributable to major disease varies substantially among the different measures. Conclusions: Primitive reflexes and measures of gait show statistically significant increases with age in multiple measurement domains, suggesting a selective age-related vulnerability. References 1. Ellenberg M. Deep reflexes in old age . JAMA . 1960;174:468-469.Crossref 2. Howell T. Senile deterioration of the central nervous system . BMJ . 1949;1:56-68.Crossref 3. Cornoni-Huntley J, Brock DB, Ostfeld AM, Taylor JO, Wallace RB. Established Populations for Epidemiologic Studies of the Elderly Resource Data Book . Washington, DC: US Government Printing Office; 1986. 4. Albert M, Smith L, Scherr P, Taylor J, Evans D. Use of brief cognitive tests to identify individuals in the community with clinicaly diagnosed Alzheimer's disease . Int J Neurosci . 1991;57:167-178.Crossref 5. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan E. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease . Neurology . 1984;34:939-944.Crossref 6. Evans DA, Funkenstein HH, Albert MS, et al. Clinically diagnosed Alzheimer's disease: an epidemiologic study in a community population of older persons . JAMA . 1989;262:2551-2556.Crossref 7. Bishop Y, Fienberg S, Holland P. Discrete Multivariate Analysis . Cambridge, Mass: MIT Press; 1975. 8. Beckett LA, Scherr PA, Evans DA. Population prevalence estimates from complex samples . J Clin Epidemiol . 1992;45:393-403.Crossref 9. Rowe J, Kahn R. Human aging: usual and successful . Science . 1987;237:143-149.Crossref 10. Villeneuve A, Turcotte J, Bouchard M, Cote JM, Jus A. Release phenomena and iterative activities in psychiatric geriatric patients . Can Med Assoc J . 1974; 110:147-153. 11. Murray MP, Kory RC, Clarkson BH. Walking patterns in healthy old men . J Gerontol . 1969;24:169-178.Crossref 12. Imms FJ, Edholm OG. The assessment of gait and mobility in the elderly . Age Ageing . 1979;8( (suppl) ):261-267.Crossref 13. Klawans HL, Tufo HM, Ostfeld AM, Shekelle RB, Kilbridge JA. Neurologic examination in an elderly population . Dis Nerv Sys . 1971;32:274-279. 14. Jenkyn LR, Reeves AG, Warren T, et al. Neurologic signs in senescence . Arch Neurol . 1985;42:1154-1157.Crossref 15. Birren JE, Casperson RC, Botwinick J. Age changes in pupil size . J Gerontol . 1950;5:216-221.Crossref 16. Kumnick LS. Pupillary psychosensory restitution and aging . J Opt Soc Am A . 1954;44:735-741.Crossref 17. Korczyn AD, Laor N, Nemet P. Sympathetic pupillary tone in old age . Arch Ophthalmol . 1976;94:1905-1906.Crossref 18. Jacobs L, Gossman MD. Three primitive reflexes in normal adults . Neurology . 1980;30:184-188.Crossref 19. Chamberlain W. Restriction in upward gaze with advancing age . Am J Ophthalmol . 1971;71:341-346. 20. Spooner JW, Sakala SM, Baloh RW. Effect of aging on eye tracking . Arch Neurol . 1980;37:575-576.Crossref 21. Skyre H. Neurological signs in a normal population . Acta Neurol Scand . 1972; 48:575-606.Crossref 22. Goff GD, Rosner BS, Detre T, Kennard D. Vibration perception in normal man and medical patients . J Neurol Neurosurg Psychiatry . 1965;28:503-509.Crossref 23. Perret E, Regli F. Age and the perceptual threshold for vibratory stimuli . Eur Neurol . 1970;4:65-76.Crossref 24. Potvin AR, Syndulko K, Tourtellotte WW, Lemmon JA, Potvin JH. Human neurologic function and the aging process . J Am Geriatr Soc . 1980;28:1-9. 25. Era P, Jokela J, Suominen H, Heikkinen E. Correlates of vibrotactile thresholds in men of different ages . Acta Neurol Scand . 1986;74:210-217.Crossref 26. Pearce J. The extrapyramidal disorder of Alzheimer's disease . Eur Neurol . 1974; 12:94-103.Crossref 27. Funkenstein HH, Albert MS, Cook N, et al. Extrapyramidal signs and other neurological findings in clinically diagnosed Alzheimer's disease: a community based study . Arch Neurol . 1993;50:51-56.Crossref 28. Kokmen E, Bossmeyer RW, Barney J, Williams JW. Neurological manifestations of aging . J Gerontol . 1977;32:411-419.Crossref 29. Levin HS, Benton AL. Age effects in proprioceptive feedback performance . Gerontol Clin . 1973;15:161-169.Crossref 30. Kaplan FS, Nixon JE, Reitz M, Rindfleish L, Tucker J. Age-related changes in proprioception and sensation of joint position . Acta Orthop Scand . 1985;56:72-74.Crossref 31. Kallman DA, Plato CC, Tobin JD. The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives . J Gerontol . 1990;45:M82-M88.Crossref 32. Larsson L, Grimby G, Karlsson J. Muscle strength and speed of movement in relation to age and muscle morphology . J Appl Physiol . 1979;46:451-456. 33. Bhatia SP, Irvine RE. Electrical recording of the ankle jerk in old age . Gerontol Clin . 1973;15:357-360.Crossref 34. Prakash C, Stern G. Neurological signs in the elderly . Age Ageing . 1973;2:24-27.Crossref 35. Severson J, Marcusson J, Winblad B, Finch C. Age-correlated loss of dopaminergic binding sites in human basal ganglia . J Neurochem . 1982;39:1623-1631.Crossref 36. McGeer P, McGeer E, Suzuki J. Aging and extrapyramidal function . Arch Neurol . 1977;34:33-35.Crossref 37. Kemper T. Clinical Neurology of Aging . New York, NY: Oxford University Press; 1984:9-52. 38. Tinetti MF, Williams FT, Mayewski R. A fall risk index for elderly patients based on number of chronic disabilities . Am J Med . 1986;80:429-434.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Comparison of Neurologic Changes in 'Successfully Aging' Persons vs the Total Aging Population

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1994.00540180051013
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To determine age-related changes in neurologic function in the general population. Design: To administer a neurologic examination to participants in such a way that it is possible to calculate the proportion of elderly persons in the population with each abnormal finding and the proportion of persons with each finding but without evidence of the medical and neurologic diseases likely to produce neurologic abnormalities (eg, stroke and diabetes). Setting: Individuals were selected from a communitydwelling population. Participants: A stratified random sample of 467 persons aged 65 years and older were evaluated. Results: Many neurologic abnormalities are increasingly common with advancing age and are present in a substantial portion of the elderly population. The prevalence of abnormal neurologic findings not attributable to disease, however, is substantially lower, typically one half to one third the total prevalence. Moreover, the increase with age in the prevalence of abnormal neurologic findings not attributable to major disease varies substantially among the different measures. Conclusions: Primitive reflexes and measures of gait show statistically significant increases with age in multiple measurement domains, suggesting a selective age-related vulnerability. References 1. Ellenberg M. Deep reflexes in old age . JAMA . 1960;174:468-469.Crossref 2. Howell T. Senile deterioration of the central nervous system . BMJ . 1949;1:56-68.Crossref 3. Cornoni-Huntley J, Brock DB, Ostfeld AM, Taylor JO, Wallace RB. Established Populations for Epidemiologic Studies of the Elderly Resource Data Book . Washington, DC: US Government Printing Office; 1986. 4. Albert M, Smith L, Scherr P, Taylor J, Evans D. Use of brief cognitive tests to identify individuals in the community with clinicaly diagnosed Alzheimer's disease . Int J Neurosci . 1991;57:167-178.Crossref 5. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan E. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease . Neurology . 1984;34:939-944.Crossref 6. Evans DA, Funkenstein HH, Albert MS, et al. Clinically diagnosed Alzheimer's disease: an epidemiologic study in a community population of older persons . JAMA . 1989;262:2551-2556.Crossref 7. Bishop Y, Fienberg S, Holland P. Discrete Multivariate Analysis . Cambridge, Mass: MIT Press; 1975. 8. Beckett LA, Scherr PA, Evans DA. Population prevalence estimates from complex samples . J Clin Epidemiol . 1992;45:393-403.Crossref 9. Rowe J, Kahn R. Human aging: usual and successful . Science . 1987;237:143-149.Crossref 10. Villeneuve A, Turcotte J, Bouchard M, Cote JM, Jus A. Release phenomena and iterative activities in psychiatric geriatric patients . Can Med Assoc J . 1974; 110:147-153. 11. Murray MP, Kory RC, Clarkson BH. Walking patterns in healthy old men . J Gerontol . 1969;24:169-178.Crossref 12. Imms FJ, Edholm OG. The assessment of gait and mobility in the elderly . Age Ageing . 1979;8( (suppl) ):261-267.Crossref 13. Klawans HL, Tufo HM, Ostfeld AM, Shekelle RB, Kilbridge JA. Neurologic examination in an elderly population . Dis Nerv Sys . 1971;32:274-279. 14. Jenkyn LR, Reeves AG, Warren T, et al. Neurologic signs in senescence . Arch Neurol . 1985;42:1154-1157.Crossref 15. Birren JE, Casperson RC, Botwinick J. Age changes in pupil size . J Gerontol . 1950;5:216-221.Crossref 16. Kumnick LS. Pupillary psychosensory restitution and aging . J Opt Soc Am A . 1954;44:735-741.Crossref 17. Korczyn AD, Laor N, Nemet P. Sympathetic pupillary tone in old age . Arch Ophthalmol . 1976;94:1905-1906.Crossref 18. Jacobs L, Gossman MD. Three primitive reflexes in normal adults . Neurology . 1980;30:184-188.Crossref 19. Chamberlain W. Restriction in upward gaze with advancing age . Am J Ophthalmol . 1971;71:341-346. 20. Spooner JW, Sakala SM, Baloh RW. Effect of aging on eye tracking . Arch Neurol . 1980;37:575-576.Crossref 21. Skyre H. Neurological signs in a normal population . Acta Neurol Scand . 1972; 48:575-606.Crossref 22. Goff GD, Rosner BS, Detre T, Kennard D. Vibration perception in normal man and medical patients . J Neurol Neurosurg Psychiatry . 1965;28:503-509.Crossref 23. Perret E, Regli F. Age and the perceptual threshold for vibratory stimuli . Eur Neurol . 1970;4:65-76.Crossref 24. Potvin AR, Syndulko K, Tourtellotte WW, Lemmon JA, Potvin JH. Human neurologic function and the aging process . J Am Geriatr Soc . 1980;28:1-9. 25. Era P, Jokela J, Suominen H, Heikkinen E. Correlates of vibrotactile thresholds in men of different ages . Acta Neurol Scand . 1986;74:210-217.Crossref 26. Pearce J. The extrapyramidal disorder of Alzheimer's disease . Eur Neurol . 1974; 12:94-103.Crossref 27. Funkenstein HH, Albert MS, Cook N, et al. Extrapyramidal signs and other neurological findings in clinically diagnosed Alzheimer's disease: a community based study . Arch Neurol . 1993;50:51-56.Crossref 28. Kokmen E, Bossmeyer RW, Barney J, Williams JW. Neurological manifestations of aging . J Gerontol . 1977;32:411-419.Crossref 29. Levin HS, Benton AL. Age effects in proprioceptive feedback performance . Gerontol Clin . 1973;15:161-169.Crossref 30. Kaplan FS, Nixon JE, Reitz M, Rindfleish L, Tucker J. Age-related changes in proprioception and sensation of joint position . Acta Orthop Scand . 1985;56:72-74.Crossref 31. Kallman DA, Plato CC, Tobin JD. The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives . J Gerontol . 1990;45:M82-M88.Crossref 32. Larsson L, Grimby G, Karlsson J. Muscle strength and speed of movement in relation to age and muscle morphology . J Appl Physiol . 1979;46:451-456. 33. Bhatia SP, Irvine RE. Electrical recording of the ankle jerk in old age . Gerontol Clin . 1973;15:357-360.Crossref 34. Prakash C, Stern G. Neurological signs in the elderly . Age Ageing . 1973;2:24-27.Crossref 35. Severson J, Marcusson J, Winblad B, Finch C. Age-correlated loss of dopaminergic binding sites in human basal ganglia . J Neurochem . 1982;39:1623-1631.Crossref 36. McGeer P, McGeer E, Suzuki J. Aging and extrapyramidal function . Arch Neurol . 1977;34:33-35.Crossref 37. Kemper T. Clinical Neurology of Aging . New York, NY: Oxford University Press; 1984:9-52. 38. Tinetti MF, Williams FT, Mayewski R. A fall risk index for elderly patients based on number of chronic disabilities . Am J Med . 1986;80:429-434.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Jun 1, 1994

References

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