Neurological and cognitive impairments detected in older people without a diagnosis of neurological or cognitive disease.

Advanced age is associated with the finding of abnormalities on neurological and cognitive assessment. This review aims to identify studies that evaluated community samples of patients without a history of neurological disease and attempts to combine these data. While neurological signs were common, they were not universal and should not be considered an inevitable component of ageing. Additionally, they are associated with an increased risk of multiple adverse outcomes including functional decline and death. Therefore they should not be considered benign. Cognitive changes detected in studies that examined healthy older adults were only mild. More pronounced change suggests the development of dementia or mild cognitive impairment (a precursor to dementia). Changes in either neurological or cognitive examination in older adults should be considered abnormal and due to underlying disease. They should be investigated and treated in a similar way to abnormalities detected in younger individuals.