A critical component of preventive medicine is the ability to first identify potential risk factors for poor health outcomes and then take action to reduce risk. Unfortunately, the signs and symptoms of medical conditions are not always easy to recognize. In a recent issue of the Archives of Internal Medicine, investigators from the University of Florence in Italy reported that subtle, but detectable, neurological abnormalities seem to be associated with a higher risk for both stroke and death.

The investigators examined 506 community-dwelling, healthy older adults (with an average age of 72.5 years) who did not have any neurological diseases. These participants underwent a 15-minute neurological assessment for subtle abnormalities, such as reduced reflexes, resting tremors, and differences in hand strength, which could be detected by standard neurological examinations. 59% of the participants had at least 1 subtle neurological abnormality, and 14% had 3 or more. The investigators found that individuals with 3 or more clinically detectable neurological abnormalities had twice the risk for both stroke and death within 8 years. They also found that a higher number of subtle neurological abnormalities predicted declines in cognition and function over a 4-year period.

This study highlights the importance of a thorough neurological examination in all older adults, even those who appear to be healthy. Early identification of at-risk individuals can help physicians to plan and implement prevention or treatment strategies to reduce the risk of stroke and death.