Clinical study
Neurological examination findings to predict limitations in mobility and falls in older persons without a history of neurological disease

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Abstract

Purpose

To estimate the prevalence of neurological signs and their association with limitations in mobility and falls in a sample of older persons without known neurological disease.

Methods

A neurologist examined 818 participants from the InCHIANTI study who were aged ≥65 years and who did not have cognitive impairment, treatment with neuroleptics, and a history of neurological disease. Mobility was assessed as walking speed and self-reported ability to walk at least 1 km without difficulty. Participants were asked to report falls that had occurred in the previous 12 months.

Results

Less than 20% (160/818) of participants had no neurological signs. Neurological signs were more prevalent in older participants and those with impaired mobility. When all neurological signs were included in sex-and age-adjusted multivariate models, 10 were mutually independent correlates of poor mobility. After adjusting for age and sex, the number of neurological signs was associated with progressively slower walking speed (P <0.001), a higher probability of reported inability to walk 1 km (P <0.001), and a history of falls (P <0.05).

Conclusion

Neurological signs are independent correlates of limitations in mobility and falls in older persons who have no clear history of neurological disease.

Section snippets

Study sample

InCHIANTI enrolled a representative sample of the residents of Greve and Bagno a Ripoli, two small towns in Tuscany, Italy. The study design and data collection methods, which have been described previously (12), were approved by the review board of the Italian National Institute of Research and Care on Aging. In brief, in August 1998, 1299 persons aged 65 years or older were randomly selected from the sample registry of the two sites. Of these, 17 men and 22 women had died or moved away from

Results

The overall prevalence of abnormal eye movements, paresis, reduced touch and proprioceptive sensitivity, tremor, and abnormal balance test (Romberg sign) was low (Table 1). However, the prevalence of other neurological signs was notably high. A Babinski sign was found in 23% (84/370) of men and 27% (120/448) of women. Twenty-three percent (191/818) of participants had muscle rigidity in one or more locations, 10% (n = 83) had asymmetrical muscle strength, 26% (n = 209) had dysmetria in the

Discussion

In a population-based sample of elderly subjects who did not have overt neurological disease and cognitive impairment, we found that the prevalence of neurological signs was high and increased with older age and the extent of limitations in mobility. Ten neurological signs were mutually independent correlates of either walking speed or the ability to walk for at least 1 km. Independent of age and sex, participants with a greater number of neurological signs tended to walk slower and were more

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  • Cited by (0)

    Supported as a “targeted project” (ICS 110.1\RS97.71) by the Italian Ministry of Health and in part by the U.S. National Institute on Aging (Contracts 916413 and 821336).

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