Peter Špalek
Many older individuals develop symptoms associated with their physiological ageing of nervous system and sense organs while current neurological disease is absent. It is necessary to know and recognize these symptoms as well as differentiate them from those manifesting neurological disease. Presbyopia in old age is caused by multiple preretinal and retinal factors. The vision is deteriorated by limited upward vertical eye movements. Presbyacusia is manifested mainly by progressive increase of acoustic treshold. After the age of 70 a gradual decrease of volume and muscle strength as well as decline in rapidity and coordination of movements develop as a physiological manifestation of ageing. Their cause is multifactorial in which the key role is played by neurogenic component (chronic partial denervation) and by muscle component (sarcopenia). In older individuals the decline in deep sensitivity, drop in vibration sensitivity lead to affected posture and gait. In concurrent reduction of muscle strength gait in healthy old subjects usually resembles that of parkinsonism - shuffling and terse, reduced synkinesis of hand in walking, anteflexed body posture. With increasing age postural tremor develops. Proper interpretation of neurological symptoms in old age is of paramount importance. Neurologist must differentiate between the symptoms of facultative and obligatory norm of physiological ageing and that of pathological neurological diseases.