[Cognitive impairment and cardiovascular disease risk factors. Project CASCADE Kraków. V. Disorders of higher cerebral functions in elderly people (65-78 years old)].

Higher cortical dysfunctions, like dysphasia, dysgnosia and dyspraxia, relatively frequent in the elderly, are related to progressive neurodegenerative or vascular disorders with dementia. The aim of the study was to assess the prevalence and the intensity of higher cerebral dysfunctions in the population over 65 years and to investigate the association between these disorders and the presence of other neurological abnormalities, i.e. extrapyramidal signs, primitive reflexes as well as cognitive impairment assessed by Mini-Mental State Examination (MMSE). There were 92 women and 90 men, aged from 65-78 years included in the study. All patients were interviewed for the presence of vascular risk factors. The battery of 21 detailed test of higher cerebral functions testing speech, calculation, reading, writing, praxia and gnosia were performed in each person. Extra-pyramidal signs and primitive reflexes were also examined. Among the disorders of higher cortical functions, slight dyspraxia was the most frequent (33.7%). Finger dysgnosia, dyscalculia and dysgraphia were found less frequently. 25.4% of studied group abnormally performed at least two tests assessing higher cortical functions and when compared with normal persons, they presented significantly more frequent the extrapyramidal signs (63.9% vs. 46.9%, respectively) and had significantly frequent impaired cognitive functions (p < 0.05). Patients with higher cortical dysfunction, when compared with other persons, had more frequent primitive reflexes (p < 0.05). The results of the study showed that slight disorders of higher cortical functions were found in about 25% of studied population; they were more frequent in people with cognitive impairment, primitive reflexes and extrapyramidal signs.