The neurology of aging

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

BACKGROUND- Several neurologic signs that are considered pathologic in younger patients are known to appear in the absence of pathology in older patients. At the same time, disorders of the nervous system are a major cause of morbidity in the aging population. Dementia is a particularly common condition in the aging population, with a steadily increasing incidence with age. REVIEW SUMMARY- The neurologic findings in the elderly are reviewed, starting with the noncognitive portion of the neurologic examination and proceeding to cognitive changes. This literature review raises several questions regarding the nature of brain aging and late-life dementia, which are explored additionally in a review of the findings of the Oregon Brain Aging Study. This is a longitudinal study of exceptionally healthy subjects older than 85 years of age in which longitudinal clinical and neuropsychologic data are complemented by longitudinal volumetric brain magnetic resonance imaging data. Neuropathologic examination of the brain has also been completed for the first cohort of brains coming to autopsy. CONCLUSIONS- The neurology of healthy aging is characterized by the appearance of specific neurologic signs, a very gradual decline in some cognitive functions, and minimal loss of brain volume. With increasing age, even in the healthiest elderly, there is an increased incidence of dementia, which is characterized by increased rates of cognitive decline and brain volume loss. The pathology associated with this dementia is classical Alzheimer disease pathology. It is possible for elderly subjects to be spared cognitive decline, brain volume loss, and Alzheimer pathology, even into the eleventh decade. Although this phenotype represents the exception rather than the rule, additional investigations of healthy aging hold promise for elucidating the mechanisms responsible for both pathologic and successful brain aging.

Original languageEnglish (US)
Pages (from-to)98-112
Number of pages15
JournalNeurologist
Volume7
Issue number2
DOIs
StatePublished - Jan 1 2001

Keywords

  • Aging
  • Balance
  • Dementia
  • Gait
  • Memory impairment

ASJC Scopus subject areas

  • Clinical Neurology

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