Neurology: Aging

Question 1

What is the primary cause of age-related presbycusis?

Answer 1

Degeneration of hair cells in the organ of corti

Question 2

What is one normal somatosensory deficit in the elderly?

Answer 2

Decreased vibratory sense in legs

Question 3

What reflex can be normally absent in the elderly?

Answer 3

Achilles Reflex

Question 4

What 3 systems need to be integrated for proper balance and gait?

Answer 4

1. Vision
2. Posterior Columns
3. Vestibular System

Question 5

Describe the palmomental reflex and how it relates to neurology as patients age.

Answer 5

Primitive reflex that is controlled by the temporal lobe but is suppressed by the frontal lobe as infants reach the toddler stage.

Consists of a twitch of the chin when stroking the palm of the hand.

Can manifest again in the elderly.

Question 6

Describe the snout reflex and how it relates to neurology as patients age.

Answer 6

Primitive reflex that is controlled by the temporal lobe but is suppressed by the frontal lobe as infants reach the toddler stage.

Involves pursing of the lips when lightly tapped with a tongue blade.

Can manifest again in the elderly.

Question 7

Describe the suckling reflex and how it relates to neurology as patients age.

Answer 7

Primitive reflex that is controlled by the temporal lobe but is suppressed by the frontal lobe as infants reach the toddler stage.

Involves stimulation of the cheek followed by an ipsilateral suckling attempt.

Can manifest again in the elderly.

Question 8

Describe the grasp reflex and how it relates to neurology as patients age.

Answer 8

Primitive reflex that is controlled by the temporal lobe but is suppressed by the frontal lobe as infants reach the toddler stage.

Involves stimulation of palm of the hand followed by flexion of the digits.

Never considered normal..

Question 9

Condition that can lead to manifestation of the frontal release signs (primitive reflexes).

Answer 9

Alzheimer Disease

Question 10

What are some mechanisms that can lead to hypothermia in the elderly?

Answer 10

• decreased metabolic rate
• decreased muscle mass and fat to produce heat
• decreased ability to vasoconstrict and conserve heat

Question 11

What are some mechanisms that can lead to hyperthermia in the elderly?

Answer 11

• reduced sweating

- decreased ability to vasodilate peripheral vessels to dissipate heat

Question 12

Why should great caution be taken when prescribing sleep medication to the elderly?

Answer 12

Can lead to falling and injury.
(the elderly often get enough sleep but don’t realize it because the accumulate sleep throughout the day and not all during the night, ex. napping)

Question 13

Name 3 cognitive causes of falling.

Answer 13

1. Apraxia
2. Normal pressure hydrocephalus
3. Multi-infarct

Question 14

Name 4 vestibular causes of falling.

Answer 14

1. Drugs (aspirin, antibiotics, diuretics)
2. Trauma
3. Surgery
4. Ménière’s disease (inner ear disease leading to vertigo)

Question 15

Name 3 proprioceptive causes of falling.

Answer 15

1. Neuropathy (diabetes)
2. Myelopathy (cervical spondylosis, B12 def.)
3. Spinal Stenosis

Question 16

What is spondylosis?

Answer 16

Degenerative osteoarthritis between vertebrae often pinching the foramina where nerves and blood vessels enter and exit the vertebral canal.

Question 17

What is the most effective prevention of falling in the elderly population?

Answer 17

Exercise