Neurological examination findings to predict limitations in mobility and falls in older persons without a history of neurological disease

Abstract Background Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. Methods Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. Results Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04–2.36), being single (OR: 5.31; 95 % CI: 3.36–37.48), having history of fall (OR: 1.86; 95 % CI: 1.19–2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02–1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45–5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12–34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01–1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77–0.97) appeared as recurrent falls predictors. Conclusions Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.

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Modification of the ventral approach to the caudal cervical spine by resection of the manubrium in a dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-09-02-0015 ◽

2009 ◽

Vol 22 (06) ◽

pp. 514-516 ◽

Cited By ~ 2

Author(s):

M. R. Owen ◽

M. A. Bush

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Cervical Spine ◽

Magnetic Resonance ◽

Neurological Examination ◽

Resonance Imaging ◽

Successful Performance ◽

Disc Material ◽

History Of ◽

Adverse Affects

SummaryA five-year-old neutered female Bassett Hound weighing 29 kg was presented with a two-day history of paraparesis. Neurological examination and magnetic resonance imaging confirmed the presence of extruded disc material ventral to the spinal cord, from the C7-T1 intervertebral disc. A ventral slot was performed to decompress the cord. In making the approach to the caudal cervical spine, the cranial aspect of the manubrium of the sternum was resected. This improved the exposure of a region normally difficult to expose via a conventional ventral approach to the cervical spine. The successful performance of the ventral slot procedure was greatly facilitated by this adaptation, which was quick and simple to perform, without any apparent adverse affects to the animal.

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The Neurologic Examination

The Brigham Intensive Review of Internal Medicine ◽

10.1093/med/9780199358274.003.0089 ◽

2014 ◽

pp. 935-940

Author(s):

Galen V. Henderson

Keyword(s):

Neurological Examination ◽

Neurological Disease ◽

Neurologic Examination ◽

Patient History ◽

Neurological Evaluation ◽

Number Of Individuals

The neurological examination is not challenging or complex. It does have many components and includes a number of skills that can be mastered only through repetition of the same techniques on a large number of individuals with and without neurological disease. Please remember that the purpose of the examination is to simply localize the lesion. Based on patient history alone, 80% of lesion locations should be known, and then a very specific neurological examination is performed to confirm the location. The examination is the less time consuming of the two parts of the patient's neurological evaluation.

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Evolutional neurologic evaluation of seven year-old children born prematurely

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x1996000300002 ◽

1996 ◽

Vol 54 (3) ◽

pp. 369-374 ◽

Cited By ~ 3

Author(s):

Lygia Ohiweiler ◽

Ligia Alfano ◽

Newra T. Rotta

Keyword(s):

Cerebral Palsy ◽

Neurological Examination ◽

Gestational Age ◽

Dynamic Balance ◽

Evaluation Criteria ◽

Control Group ◽

Developmental Disturbances ◽

Limb Coordination ◽

History Of ◽

Trunk Limb

A sample of 51 children aged 7 with a history of prematurity was compared to 44 age-matched children who were born at term at the HCPA. The premature children had had gestational ages up to 37 weeks and 6 days and were born weighing less than 2500g. The control group consisted of children born with gestational age between 38 and 42 weeks and weights above 2S00g. The evaluation criteria were clinical examination, neurological examination and the evolutional neurological evaluation (ENE). The results pointed out that impulsiveness, aggressiveness, disorganization and enuresis were prevalent symptoms of developmental disturbances in the sample of prematures. Alterations at neurological examination did not discriminate between the two groups, although cerebral palsy occurred only in the proup of prematures. The ENE functions which differentiated the two groups studied were dynamic balance, appendicular and trunk-limb coordination and motor persistence.

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Huntington’s disease-like 2: a phenocopy not to miss

Practical Neurology ◽

10.1136/practneurol-2020-002590 ◽

2020 ◽

Vol 20 (6) ◽

pp. 479-481

Author(s):

Daniel Sabino De Oliveira ◽

Daniela Pereira Santos ◽

Daniel Oliveira Araujo ◽

Pedro José Tomaselli ◽

WIlson Marques Júnior ◽

...

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Genetic Counselling ◽

Neurological Examination ◽

Clinical Management ◽

African Ancestry ◽

Epileptic Seizures ◽

Correct Identification ◽

History Of ◽

Slow Saccades

A 67-year-old Brazilian man of African ancestry and his 60-year-old sister both presented with choreiform movements, although in the man these were significantly overshadowed by additional parkinsonism. The man also had a history of four epileptic seizures. Neurological examination in each also found slow saccades and a dysexecutive syndrome. Genetic tests for Huntington’s disease were negative but were positive for Huntington’s disease-like 2. There are various genetic causes of chorea diseases, and their correct identification is important for appropriate clinical management and genetic counselling.

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Vowel Acoustics in Dysarthria: Speech Disorder Diagnosis and Classification

Journal of Speech Language and Hearing Research ◽

10.1044/1092-4388(2013/12-0262) ◽

2014 ◽

Vol 57 (1) ◽

pp. 57-67 ◽

Cited By ~ 58

Author(s):

Kaitlin L. Lansford ◽

Julie M. Liss

Keyword(s):

Neurological Disease ◽

Classification Scheme ◽

Function Analysis ◽

Group Differences ◽

Means Testing ◽

Healthy Control ◽

History Of ◽

Diagnosis And Classification ◽

Dysarthric Speech ◽

Second Formant

Purpose The purpose of this study was to determine the extent to which vowel metrics are capable of distinguishing healthy from dysarthric speech and among different forms of dysarthria. Method A variety of vowel metrics were derived from spectral and temporal measurements of vowel tokens embedded in phrases produced by 45 speakers with dysarthria and 12 speakers with no history of neurological disease. Via means testing and discriminant function analysis (DFA), the acoustic metrics were used to (a) detect the presence of dysarthria and (b) classify the dysarthria subtype. Results Significant differences between dysarthric and healthy control speakers were revealed for all vowel metrics. However, the results of the DFA demonstrated some metrics (particularly metrics that capture vowel distinctiveness) to be more sensitive and specific predictors of dysarthria. Only the vowel metrics that captured slope of the second formant (F2) demonstrated between-group differences across the dysarthrias. However, when subjected to DFA, these metrics proved unreliable classifiers of dysarthria subtype. Conclusion The results of these analyses suggest that some vowel metrics may be useful clinically for the detection of dysarthria but may not be reliable indicators of dysarthria subtype using the current dysarthria classification scheme.

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Yellow fever vaccine-associated neurological disease: it is not just the silver generation at risk

BMJ Case Reports ◽

10.1136/bcr-2019-229558 ◽

2019 ◽

Vol 12 (5) ◽

pp. e229558 ◽

Cited By ~ 3

Author(s):

Emily J Goldstein ◽

David J Bell ◽

Rory N Gunson

Keyword(s):

Yellow Fever ◽

Neurological Disease ◽

White Cell Count ◽

Sudden Onset ◽

Yellow Fever Vaccine ◽

Viral Pathogens ◽

Elevated Protein ◽

History Of ◽

Simplex Virus ◽

Sixth Nerve

A 35-year-old man presented to his optician with sudden onset diplopia and a 1-week history of headaches. He was noted to have sixth nerve palsy. The following day he was admitted to hospital with confusion and expressive dysphasia. He had been due to travel to Ghana on business and had received yellow fever (YF) vaccination 18 days prior to onset of headaches. His initial cerebrospinal fluid (CSF) revealed elevated protein, increased white cell count but was PCR negative for standard viral pathogens. Herpes simplex virus (HSV)-1 was detected by PCR in CSF at a very low level from a second lumbar puncture performed 6 days later, and the patient was treated for HSV meningoencephalitis. However, retrospective investigation for yellow fever vaccine-associated neurological disease revealed increasing titres of YF IgG in three serial CSF samples, and no evidence of HSV antibodies in CSF or plasma, ruling out HSV encephalitis.

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The history of the neurological examination. Part 1: Ancient and pre‐modern history ‐ 3000 BC to AD 1850

Journal of the History of the Neurosciences ◽

10.1080/09647049209525509 ◽

1992 ◽

Vol 1 (1) ◽

pp. 3-14 ◽

Cited By ~ 7

Author(s):

Bernard M. Patten

Keyword(s):

Neurological Examination ◽

Modern History ◽

History Of

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Assessment of healthcare and placement needs in an older forensic psychiatric population in comparison to a younger forensic psychiatric population

International Psychogeriatrics ◽

10.1017/s1041610212000130 ◽

2012 ◽

Vol 24 (7) ◽

pp. 1188-1190 ◽

Cited By ~ 3

Author(s):

Kavita Das ◽

Kevin Murray ◽

Rick Driscoll ◽

S. Rao Nimmagadda

Keyword(s):

Heart Disease ◽

Neurological Disease ◽

Older Patients ◽

The Elderly ◽

Healthcare Provision ◽

Medical Problems ◽

Older Offenders ◽

History Of ◽

Psychiatric Population ◽

Forensic Psychiatric

The healthcare provision for the elderly with a history of offending is under-researched and suffers from a lack of adequate services. Although the number of offences committed by older patients is low, research suggests they are more likely to re-offend, and have significant legal and psychiatric histories (Tomar et al., 2005). Older offenders also have complex medical problems such as neurological disease, including dementia, heart disease, stroke, and hypertension (Lewis et al., 2006).

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