Approach to unsteadiness, gait disturbance, or falls Quiz: Ace Your Exams
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A 70-year-old man presents to the primary care clinic for evaluation of frequent falls. For the past six months, the patient has felt unsteady, and his partner has noticed some cognitive decline. Past medical history includes hyperlipidemia treated with simvastatin. Temperature is 37.0°C (98.6°F), pulse is 84/min, respirations are 14/min, and blood pressure is 128/82 mmHg. On physical examination, the patient is alert and expressive. Strength and tone are normal in all four extremities. Gait initiation is hesitant, and he walks with a forward-bent posture, taking short, shuffling steps. There is difficulty with turning – the patient's head, trunk, and pelvis rotate as a single unit. Arm swing is normal. Which additional historical finding is most likely to be present?
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