Simple doctor's exam may predict stroke risk: study

A simple doctor's examination for subtle problems such as reduced reflexes or unstable posture could help predict which healthy elderly people are at the highest risk of death or stroke, researchers said on Monday.

Those with more than three of these abnormalities, which include tremors and differences in hand strength, were more likely to die, according to an Italian study conducted over an eight-year period.

"A simple neurological examination seems to be an additional prognosticator of hard outcomes, particularly death above and beyond other measures used in clinical practice," Marco Inzitari of the University of Florence and colleagues wrote in the Archives of Internal Medicine.

"It is likely that the neurological examination might capture additional information about the integrity of the nervous system in apparently healthy older adults."

Minor mental problems often spur doctors to send older, apparently healthy patients for brain tests to check for atrophy, tumors, strokes or other neurological problems.

Previous research has linked some of these to physical problems and the latest findings may provide another tool to treat mental decline in an ageing population, Inzitari said.

"Our data support the hypothesis that subtle neurological abnormalities in elderly individuals are a manifestation of early brain damage, a finding that may have important implications in research studies on the prevention of age-related cognitive and functional decline," he wrote.

The Italian team studied 506 people with an average age of about 73 who had no signs of neurological disease when the research began in 1995.

The researchers conducted neurological exams at the beginning of the study and again four years later. They also tracked deaths and strokes for an average of eight years.

After taking account of age, sex and other factors, they found people with fewer than three abnormalities were less likely to die or suffer a stroke over the eight years. When the study began, 59 percent of the volunteers had at least one abnormality.

"Understanding the nature of dysfunctions underlying the decline in physical performance and disability contributes to planning specific preventive interventions," they wrote.