Cognitive Decline Exam Could Aid in Prevention
> 6/26/2008 4:19:23 PM

Older adults often fear strokes, dementia, and other neurological conditions associated with aging, but new research from the Archives of Internal Medicine suggests that a brief exam could go a long way to identifying those most at risk for these health problems. A team of Italian researchers from the University of Florence tested a group of seniors, looking specifically for neurological symptoms that often indicate a physical disease or condition. Their results show that these symptoms may also point toward an increased likelihood of cognitive decline and death.

Over 500 subjects 65 or older participated in the study, which began in 1995. They received an initial neurological examination and were then re-examined four years later. During both examinations, the researchers looked specifically for “subtle neurological abnormalities” such as weak muscle strength, poor reflexes, unsteady posture, problems with balance, and resting tremors. Although none of the subjects had a neurological condition at the study’s start, nearly 60 percent had at least one neurological abnormality.

The researchers collected data on the subjects’ health up until 2003, focusing on the incidence of stroke, cardiovascular problems, dementia, and death. By the study’s end, 113 subjects had died and 62 had suffered strokes. Analysis showed that those who developed more neurological abnormalities over time had a higher risk of experiencing depressive symptoms and cognitive decline. Additionally, the researchers found an association between an increased number of abnormalities and a subject’s likelihood of having significant health problems or dying, even when age, sex, and other health conditions were taken into account. Those with three or more abnormalities had a 77 percent greater chance of dying compared to subjects with fewer than three.

Neurological abnormalities should not be ignored, and this study provides evidence that brief exams designed to test for these symptoms can be effective at determining those most at risk for health problems. In an editorial piece also published in the Archives of Internal Medicine, researchers from the Indiana University Center for Aging Research call for neurological exams to become standard in the care of healthy older adults. While a patient may not have been diagnosed with a neurological condition, the presence of three or more abnormalities could be the first signs of a problem, and this exam could be the tool that allows physicians to identify those with a higher chance of experiencing problems and beginning treatment early on.

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