Table 5.5.

Changes in the neurological examination with aging

Smaller pupil size and reduced reactivity

Decreased near vision (presbyopia)

Breakdown of smooth eye pursuits with saccadic intrusions

Reduced upgaze and convergence

High-frequency hearing loss

Mild increase in muscle tone, decrease in muscle bulk, and subtle reduction in strength

Decreased vibration sense in distal lower extremities

Absent ankle jerk reflexes

Presence of primitive reflexes

Gait with slight stoop, slower speed, and reduced tandem ability