Age-Related Signs

Age-Related Signs

A number of neurological signs are reported to be more prevalent with increasing age and related to ageing per se rather than any underlying age-related disease, hence not necessarily of pathological significance when assessing the neurological status of older individuals, although there are methodological difficulties in reaching such conclusions. A brief topographical overview of age-related signs (more details may be found in specific entries) includes:

• Cranial nerves:
  • I: olfactory sense diminished
    II, III, IV, VI: presbyopia; reduced visual acuity, depth perception, contrast sensitivity, motion perception; "senile miosis"; restricted upward conjugate gaze
    VIII: presbycusis; impaired vestibulospinal reflexes
• Motor system:
  • Appearance: loss of muscle bulk; "senile" tremor
    Tone: rigidity; gegenhalten/paratonia
    Power: decline in muscle strength
    Coordination: impaired speed of movement (bradykinesia)
• Reflexes:
• Phasic muscle stretch reflexes: depressed or absent, especially ankle (Achilles tendon) jerk; jaw jerk
  Cutaneous (superficial) reflexes: abdominal reflexes may be depressed with ageing
  Primitive/developmental reflexes: glabellar, snout, palmo-mental, grasp reflexes may be more common with ageing
  Impairments of gait; parkinsonism
• Sensory system:

• Decreased sensitivity to vibratory perception; +/− pain, temperature, proprioception

Neuroanatomical correlates of some of these signs have been defined. There does seem to be an age-related loss of distal sensory axons and of spinal cord ventral horn motor neurones accounting for sensory loss, loss of muscle bulk and strength, and reflex diminution.

References
Franssen EH. Neurologic signs in ageing and dementia. In: Burns A (ed.). Ageing and dementia: A methodological approach. London: Edward Arnold, 1993: 144-174
Larner AJ. Neurological signs of aging. In: Pathy MSJ, Morley JE, Sinclair A (eds.). Principles and practice of geriatric medicine (4th edition). Chichester: Wiley, 2005: (in press)

Cross References

Frontal Release Signs; Parkinsonism; Reflexes