Geriatric Neurological Exam and Differential Diagnosis

Course overview

In the older adult, a thorough examination is critical to determine the nature of the presenting symptoms. Age-related changes, combined with other determinants of health and the presence of multimorbidities, complicate the evaluation process, particularly for older adults presenting with neurologic symptoms. This course will present a comprehensive overview of differential diagnosis and clinical decision-making for the physical therapist providing care for geriatric patients across multiple neurologic diagnoses. Typical age-related changes in the neurologic system will be reviewed and distinguished from neurologic signs and symptoms related to neurological pathology. Discussion combined with demonstration will take the clinician through strategies for medical screening, upper and lower quarter screening, and movement observation for individuals with neurologic deficits. Neurological examination strategies, including discussion of common activity limitations and impairments based on the ICF Disablement Model, will be discussed. Contributions of the history and physical examination findings, the social determinants of health, and the movement system to the clinical decision-making process will be evaluated to determine if neurologic presentation is within the physical therapist's scope of practice or requires referral/communication to another healthcare professional. The course is designed for beginner to intermediate clinicians to hone their screening and clinical decision-making skills specific to the care of individuals with neurologic deficits in multiple clinical settings, including home health, outpatient, hospital-based, and rehabilitation.