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Older adults frequently present with a primary com-plaint that is neurologic in origin, and neurologic disorders are the primary cause of disability in older adults. These disorders account for 50% of disability in people over 65 years of age and for more than 90% of serious dependency (Drachman, Long, & Swearer, 1994). As a result, the per-
Clinical evaluation of neurologic disorders in the elderly requires seeking a thorough history and performing an age-appropriate neurologic examination with special attention to changes that occur with normal aging.
This dilemma is emphasized in this book, which reviews commonly encountered neurologic problems in the elderly population—confusion, balance disorders, headache, visual disturbances, incontinence, movement disorders, loss of consciousness, and dysfunction of the extremities.
Interpretation of neurological signs in the elderly depends on context: factors that must be taken into account include the influence of comorbidities, the problems of extrapolating group data to individuals and the influence of presymptomatic or asymptomatic disease.
Neurological disorders in older people result in many acute hospital admissions and substantial long-term disability. Although neurologists treat many older people and geriatricians treat many neurological disorders, there are often few links between the two specialties.
Ageing is associated with changes in the nervous system with consequent alterations in some neurological examination findings: understanding what is 'normal' at different ages is essential when evaluating patients.
Clinical evaluation of neurologic disorders in the elderly requires seeking a thorough history and performing an age-appropriate neurologic examination with special attention to changes that occur with normal aging.