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Old 05-19-2011
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Originally Posted by Dr.kaushik View Post
why not A be the answer??.....DTR is more valuable to physician...patients age is 77 ....Vibration sense is subjective.....
peripheral neuropathy should be suspected....causes both decrease vibration, decreased DTR....
though not sure..
senile dementia and HF hearing loss common at such age...
Because decreases ankle reflexes are quite normal in the elderly. I don't have time to find a good source to validate that, but I did find the following, which echoes what I have been taught in my clinical rotations:


Individuals are unique in their psychological and physical aging process. As the individual ages, there is a quantitative loss of cells and changes in many of enzymatic activities within cells resulting in a diminished responsiveness to biological demands made on the body. Age related a change occurs at different rate in different people.


The brain atrophies as a result of aging process. The brain weight decreases, decrease in enzymes, protein and lipids in brain tissue.
There is shrinkage of large neurons resulting in loss of large neurons with an increase in smaller neurons.
There is alterations in the amount for some neuro-transmitters.
Clinical changes due to the above are decreased sensation of vibrations(particularly in legs), less brisk deep tendon reflexes with ankle reflex absent entirely and a decreased ability for upward gaze.
Functional changes include slowing of response to tasks and the increase in time to recover from physical exertion
Cognitive changes include memory loss, decrease in perceptual ability and decrease in proficiency.

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The above post was thanked by:
blackychen (10-09-2015), Dr.kaushik (05-19-2011)