The Neurological Examination in Aging, Dementia and Cerebrovascular Disease Part 4: Reflexes and Sensory Examination

This four-part series of articles provides an overview of the neurological examination of the elderly patient, particularly as it applies to patients with cognitive impairment, dementia or cerebrovascular disease.The focus is on the method and interpretation of the bedside physical examination; the mental state and cognitive examinations are not covered in this review.Part 1 (featured in the September issue) began with an approach to the neurological examination in normal aging and in disease, and reviewed components of the general physical,head and neck,neurovascular and cranial nerve examinations relevant to aging and dementia.Part 2 (featured in the October issue) covered the motor examination with an emphasis on upper motor neuron signs and movement disorders. Part 3(featured in the November issue) reviewed the assessment of coordination,balance and gait,and Part 4, featured here, discusses the muscle stretch reflexes, pathological and primitive reflexes, and sensory examination, and offers concluding remarks.Throughout this series, special emphasis is placed on the evaluation and interpretation of neurological signs in light of findings considered normal in the elderly.