The yearly clinical evaluations included a history and neurological examination, measurement of visual acuity, measurement of blood pressure, completion of detailed questionnaires regarding medical history, a Tinetti gait and balance scale test (maximum score, 28),1 Mini-Mental State Examination (MMSE) (maximum score, 30),7 a Purdue Pegboard motor assessment,8 and auditory and vestibular function testing.9 Subjects reported the number of falls (to the ground) that had occurred during the past year. In the initial interview, they were instructed to keep track of all falls that occurred during the year. The neurological examination was performed by one of us (R.W.B.). Gait features such as base width, stride length, and turning were evaluated, and the degree of impairment was graded as follows: 0, normal; 1, mild; 2, moderate; and 3, severe. Lower extremity vibration (256-Hz tuning fork) sensation was assessed, and the degree of impairment (compared with the examiner) was graded as follows: 0, normal; 1, mildly decreased; 2, moderately decreased; and 3, severely decreased. Deep tendon reflexes (DTRs) were graded on a scale of 0 to 2 (0, trace or absent; 1, low normal; and 2, high normal). A trained technician scored the Tinetti gait and balance examination, which grades such features as gait speed, stride, symmetry, and balance while standing, turning, nudging, and with eye closure. For the Purdue Pegboard Test, the total number of pins inserted in 30 seconds for the dominant, the nondominant, and both hands was summed. Subjects picked up a single pin from a small disk containing multiple pins and placed them in holes in the board. Visual acuity was tested using a standard Snellen chart, with best-corrected visual acuity in logMAR units (−log10 Snellen ratio).