neurologic disorders
Weakness
Geriatrics Essentials: Weakness
Some decrease in deep tendon reflexes is common with aging, but asymmetry or absence of these reflexes with augmentation is abnormal. Because older adults are more likely to have preexisting sarcopenia, bed rest can cause debilitating muscle wasting rapidly, sometimes after only several days. Older adults take more medications and are more susceptible to drug-induced myopathies, neuropathies, and fatigue; thus, medications are a common cause of weakness in older adults. Feeling too weak to walk often has multiple causes. Factors may include the following: Muscle weakness (eg, caused by stroke, use of certain substances or medications, myelopathy due to cervical spondylosis, or muscle atrophy) Hydrocephalus Parkinsonism Painful arthritis Age-related loss of neural networks mediating postural stability (vestibular system, proprioceptive pathways), coordination (cerebellum, basal ganglia), vision, and praxis (frontal lobe) Evaluation should focus on reversible factors. Physical therapy and rehabilitation are generally helpful no matter what the etiology of the weakness is. 