Neurological assessment of older adults: A crystal ball to the future

Standard neurological exams of older adults are good predictors of future brain health and quality of life. These tests should become part of the physician's routine examination of older adults say faculty from the Indiana University Center for Aging Research in an editorial in the June 23, 2008 issue of the Archives of Internal Medicine.

The editorial accompanies a study by Italian researchers who used data obtained from standardized neurological exams to devise a simple scale measuring the total number of subtle neurological abnormalities found among disability-free older adults. The Italian study found that a higher number of subtle neurological abnormalities in patients without cognitive impairment at baseline predicted both cognitive and functional declines.

"The Italian study confirms that looking at subtle neurological abnormalities in healthy older adults gives the doctor an insight into factors that contribute to impairment of functional cognition which lead to disability and poor quality of life," said editorial co-author Malaz Boustani, M.D., M.P.H, an assistant professor of medicine at Indiana University School of Medicine, an Indiana University Center for Aging Research investigator and a Regenstrief Institute research scientist.

"Until now we haven't had proof of value of the standard neurological exam. We now know that the test is a good value for older adults and could even be used as a "cheap biomarker" of future cognitive decline because it appears to have predictive value similar to biomarkers," said Dr. Boustani.

More than 12 percent of the U.S. population is aged 65 and older. This percentage will increase to 20 percent by 2030.

Someone in the United States develops Alzheimer's disease every 72 seconds, according to the Alzheimer's Association. The average primary care physician, the doctors who see most older adults, sees 2,000 patients per year of whom 300 are aged 65 or older. Of these 24 will develop dementia.

Co-author of the Archives of Internal Medicine editorial is Michael D. Justiss, Ph.D., assistant professor of occupational therapy at the IU School of Health and Rehabilitation Sciences, which along with the IU School of Medicine and the Regenstrief Institute, is located on the campus of Indiana University-Purdue University Indianapolis.