Nichols M E, Meador K J, Loring D W, Poon L W, Clayton G M, Martin P
Department of Neurology, Medical College of Georgia, Augusta 30912-3200.
J Geriatr Psychiatry Neurol. 1994 Jan-Mar;7(1):1-7. doi: 10.1177/089198879400700101.
Although numerous studies have focused on age-related changes in the nervous system, few have systematically assessed global neurologic examination changes, and even fewer have included the most elderly population, ie, the centenarians. To perform such a study, we developed a quantitative assessment that includes the major components of a standard bedside neurologic evaluation, with special emphasis on cognitive function. First, we demonstrated that the quantitated examination could correctly classify healthy controls and patients with stroke or dementia based on discriminant analysis. This examination was then applied to healthy community-dwelling elderly ranging from 60 to 108 years of age. Significant age-related neurobehavioral changes were apparent across even these most "successfully" aged groups. Analysis of the full pattern of cognitive and neurologic findings provided the most accurate assessment. Pathologic reflexes, reportedly associated with normal aging, occurred infrequently in this healthy geriatric population, suggesting that age-related changes in the neurologic examination may be more accurately interpreted when assessed in conjunction with cognitive status. This quantitative examination may be useful in future population-based studies of neurologic function in the aged.
尽管众多研究聚焦于神经系统的年龄相关变化，但很少有研究系统地评估全面的神经系统检查变化，而将最年长人群（即百岁老人）纳入研究的则更少。为开展此类研究，我们开发了一种定量评估方法，该方法涵盖标准床边神经系统评估的主要组成部分，并特别强调认知功能。首先，我们证明了基于判别分析，定量检查能够正确区分健康对照者与中风或痴呆患者。然后，将该检查应用于年龄在60岁至108岁之间居住在社区的健康老年人。即使在这些最“成功”衰老的群体中，也明显存在与年龄相关的显著神经行为变化。对认知和神经学检查结果的全面模式分析提供了最准确的评估。据报道与正常衰老相关的病理反射在这群健康的老年人群中很少出现，这表明在结合认知状态进行评估时，神经系统检查中与年龄相关的变化可能会得到更准确的解读。这种定量检查可能对未来基于人群的老年神经功能研究有用。
