From Our 2011 Archives

Are Signs of Old Age Really Something More Serious?

Study: Shaky Hands, Trouble Walking May Be Signs of Tiny Brain Lesions

By Denise Mann
WebMD Health News

Reviewed by Laura J. Martin, MD

Aug. 31, 2011 -- Shaky hands, a stooped posture, and slower walking are often written off as normal signs of aging, but they may be more than that. These symptoms may be signs of tiny blocked blood vessels in the brain.

"What we think of as normal aging may not be so normal after all," says researcher Aron S. Buchman, MD. He is an associate professor of neurological sciences at Rush University Medical School in Chicago.

Researchers examined 1,100 older nuns and priests every year starting in 1994; the nuns' and priests' brains were donated to science after they died. There were tiny lesions or blocked blood vessels -- only visible via microscope -- seen in the brains of 30% of 418 people who died.

These participants were about 88 on average when they died, and none showed any signs of brain disease or stroke when living. These changes are so small that they would have been missed by available brain scans.

Those who had the hardest time walking were more likely to have multiple lesions in their brains, the study showed. Two-thirds had at least one blood vessel abnormality in their brain upon examination after death.

The new findings appear in Stroke.

Can Anything Be Done?

As part of the study, researchers observed "normal" signs of aging, including:

  • Balance
  • Posture
  • Walking speed
  • Ability to get in and out of a chair (chair test)
  • Ability to turn while walking
  • Dizziness

"As people get older, even if they don't have diseases like stroke or Parkinson's disease, they do slow down," Buchman says.

So just what does this mean for people in their 80s?

High blood pressure, high cholesterol, and diabetes are known risk factors for stroke and blood vessel disease. So someone who has abnormal muscle function or movement should be assessed for such risk factors and may want to aggressively lower these risks, Buchman tells WebMD.

"We do have medications available to treat these risk factors, and we could be more aggressive about lifestyle changes, such as increasing physical activity and losing weight," he says. This is especially important because there are not yet any scans powerful enough to detect the tiny blocked blood vessels.

Still, this study was based on observation, so it is too early to say what effect these changes could have on the strength of people's muscles or their ability to effectively get around.

It May Be More Than Old Age

Roger Bonomo, MD, director of stroke care at New York's Lenox Hill Hospital, puts it this way. "Being old doesn't mean you have to walk like you have Parkinson's disease, so rather than saying 'oh it's just age,' see a neurologist," he says.

That is good advice, says Roy Alcalay, MD, an assistant professor of neurology at Columbia University Medical Center in New York City.

Parkinson's disease is different than parkinsonian symptoms, says Alcalay, who is also an advisor for the Parkinson's Disease Foundation. "A lot of older people may have parkinsonian symptoms, but not Parkinson's disease," he says. Parkinson's disease is a progressive movement disorder that also may impair memory and comprehension.

This study only speaks to parkinsonian symptoms. "It may be that these brain changes also impair gait and quality of life among people as they age," he tells WebMD.

The key word is may, he says.

The question that remains is whether treating blood pressure or cholesterol would make a difference on these symptoms. On the flip side, given the rising rates of obesity, which often travels with high blood pressure, cholesterol, and diabetes, growing numbers of people may develop the disabilities, he says.

SOURCES: Buchman A. Stroke, study received ahead of print.Aron S. Buchman MD, associate professor, neurological sciences, Rush University Medical School, Chicago.Roy Alcalay, MD, assistant professor, neurology, Columbia University Medical Center, New York City.Roger Bonomo, MD, director, stroke care, Lenox Hill Hospital, New York. ©2011 WebMD, LLC. All Rights Reserved.