Age-Related Changes in the Neurologic Examination of Healthy Sexagenarians, Octogenarians, and Centenarians

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Abstract
Although numerous studies have focused on age-related changes in the nervous system, few have systematically assessed global neurologic examination changes, and even fewer have included the most elderly population, ie, the centenarians. To perform such a study, we developed a quantitative assessment that includes the major components of a standard bedside neurologic evaluation, with special emphasis on cognitive function. First, we demonstrated that the quantitated examination could correctly classify healthy controls and patients with stroke or dementia based on discriminant analysis. This examination was then applied to healthy community-dwelling elderly ranging from 60 to 108 years of age. Significant age-related neurobehavioral changes were apparent across even these most “successfully” aged groups. Analysis of the full pattern of cognitive and neurologic findings provided the most accurate assessment. Pathologic reflexes, reportedly associated with normal aging, occurred infrequently in this healthy geriatric population, suggesting that age-related changes in the neurologic examination may be more accurately interpreted when assessed in conjunction with cognitive status. This quantitative examination may be useful in future population-based studies of neurologic function in the aged.