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Nerves are the pathways that carry signals to and from your brain and the rest of your body. The spinal cord is the bundle of nerves that runs from your brain down the center of your back. Nerves extend out from the spinal cord to every part of your body. As you age, your brain and nervous system go through natural changes. Your brain and spinal cord lose nerve cells and weight (atrophy). Nerve cells may begin to pass messages more slowly than in the past. Waste products or other chemicals such as beta amyloid can collect in the brain tissue as nerve cells break down. This can cause abnormal changes in the brain called plaques and tangles to form.

Breakdown of nerves can affect your senses. You might have reduced or lost reflexes or sensation. This leads to problems with movement and safety. Slowing of thought, memory, and thinking is a normal part of aging. These changes are not the same in everyone. Some people have many changes in their nerves and brain tissue. Others have few changes. These changes are not always related to the effects on your ability to think. Thinking and behaviour problems can also be caused by poorly controlled diabetes. Rising and falling blood sugar levels can interfere with thought.

  • Talk with your doctor if you have any changes in –
  • Memory
  • Thought
  • Ability to perform a task
  • Mental and physical exercise can help your brain stay sharp. Mental exercises include –
  • Reading
  • Doing crossword puzzles
  • Stimulating conversation

Physical exercise promotes blood flow to your brain. It also helps reduce loss of brain cells. The aging nervous system and the pericardial structures are particularly sensitive to various mechanisms of HA. Between 3rd and 10th decades of life the average male brain loses 233 grams as the neuronal population of the neocortex becomes progressively depleted. Also cerebral uptake of Oxygen and Glucose is reduced. Extracranial muscle loses cells and undergoes atrophy Collagen also diminishes in integrity and functions.

These generalised changes result in enhanced susceptibility to a wide range of pathological conditions related to the brain. Although certain primary headaches like hypnic headache and primary cough headache occur more commonly in elderly, the prevalence and incidence of migraine decreases with age. Secondary headaches encountered in elderly are temporal arteritis, cerebral hemorrhage, brain tumor sleep apnoea meningitis, and glaucoma. Migraine in elderly patients is usually bilateral and is less likely to have migraine associated symptoms like photophobia and phonophobia compared to young patients.

Many sleep related headaches like hypnic headache, cluster headache can occur in elderly. Hypnic headaches occur only during sleep and causes awakening. It is also called Alarm Clock Headache or Clockwise Headache. It lasts for 15 minutes to 4 hours. A cup of coffee can relieve a headache.

Elderly patients may have depression or anxiety in one of its several forms. These are associated with headaches. As psychiatric symptoms subside, headache usually disappears. Dental procedures and sinus infection precipitate headache and careful evaluation is needed. Cardiac cephalgia is an uncommon but important cause of headache in elderly. There may be only headaches without chest pain. Response to nitrates (taking sorbitrate under tongue) aids in diagnosis. Distinguishing this particular headache from migraine is important as Triptans and Ergots are contraindicated. Awareness of this condition is scarce as it is often unrecognised and underreported.

Dialysis related headaches commonly occur during haemodialysis and are resolved within 72 hours of completion of haemodialysis session. Headache usually ceases after successful renal transplantation. Headache is common in patients with stroke. Headaches are associated with. Various disorders that lead to severe and paroxysmal elevation of blood pressure. Ambulatory blood pressure monitoring is sometimes advised in patients with moderate to severe hypertension.

Ageing can have profound effects on the post-mitotic organ of behaviour, the brain. As yet the precise causes of these deleterious effects are unknown. However, clear insights into the putative mechanisms and consequences of ageing in the CNS have been achieved through the use of invertebrate models. It is now clear that ageing alters the endogenous properties of neurons, their morphology, and the efficacy of the connections that the neurons make with their targets and may even lead to neuron loss. It is clear to date that the age-induced changes in CNS function observed in invertebrates are conserved in mammalian species and that further work on invertebrates may provide informative insights into the mechanisms of neuronal ageing.

Dr. Ansu Sen, MD/DM Neurology, Senior Consultant (Neurologist), Ramakrishna Mission Sewa Prathisthan, Manipal Hospitals, Kolkata

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