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(3) PT in Special Conditions > S1L3: Conditions and Diseases in the Elderly > Flashcards

S1L3: Conditions and Diseases in the Elderly Flashcards

1
Q

Age and disease-related loss of adaptation, such that events of previously minor stress result in proportionate biomedical and social consequences

A

FRAILTY

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2
Q

To consider Fraility as a Clinical Syndrome, it should have how many of the ff?

  1. Unintentional weight loss of at least 10 lb over the past year
  2. Self-reported-exhaustion
  3. Weakness (grip strength)
  4. Slow walking speed
  5. Low physical activity
A

3 or more

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3
Q

To consider Fraility as a Clinical Syndrome, it should have 3 or more of the ff: (5)

A
  1. Unintentional weight loss of at least 10 lb over the past year
  2. Self-reported-exhaustion
  3. Weakness (grip strength)
  4. Slow walking speed
  5. Low physical activity
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4
Q

Frailty can be attributable to: (3)

A

aging, diseases, and comorbidity

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5
Q

Frailty is not included as a category for patients at risk for adverse outcomes

True or False

A

False

Category of patients at risk for adverse outcomes

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6
Q

Disuse and Immobilization exacerbates the decline in body systems

True or False

A

True

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7
Q

Disuse and Immobilization is a combination of ______(2) which lead to negative effects of bed rest

A

inactivity and lack of mechanical loading

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8
Q

Disuse and immobilization leads to decreased muscle insulin resistance

True or False

A

False (Increased muscle insulin resistance)

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9
Q

Disuse and immobilization increases bone loss

True or False

A

True

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10
Q

Disuse and immobilization decreases pulmonary function and exercise capacity

True or false

A

True

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11
Q

Major cause of morbidity

A

FALLS

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12
Q

Cause of majority of fractures of the forearm, pelvis, hip, pelvis

A

FALLS

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13
Q

Risk factors for falls in the elderly: (8)

A
  1. Age
  2. Physical impairments
  3. Cognitive impairment, dementia, depression
  4. Previous falls
  5. Medications
  6. Comorbid conditions
  7. Chronic pain & arthritis
  8. Poor functional status
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14
Q

RECOMMENDATIONS FOR FALL AND INJURY PREVENTION IN THE ELDERLY:

Treating vitamin D deficiency (at least ____ international units per day)

A

700

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15
Q

RECOMMENDATIONS FOR FALL AND INJURY PREVENTION IN THE ELDERLY:

Careful, medically directed tapering of _____

A

high-risk medications

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16
Q

RECOMMENDATIONS FOR FALL AND INJURY PREVENTION IN THE ELDERLY:

Addressing ______ pain and dysfunction

A

foot/ankle

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17
Q

RECOMMENDATIONS FOR FALL AND INJURY PREVENTION IN THE ELDERLY:

____ surgery and ____ if indicated.

A

Cataract

dual chamber cardiac pacing

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18
Q

Tai Chi can be recommended for fall and injury prevention in the elderly

True or False

A

True

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19
Q

Generalized, group, and home-based exercises can be recommended for fall and injury prevention in the elderly

True or False

A

False

Individualized, group, and home-based exercises can be recommended for fall and injury prevention in the elderly

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20
Q

Fall risk assessment by qualified healthcare professionals or teams can be recommended for fall and injury prevention in the elderly

True or False

A

True

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21
Q

ADs can be recommended for fall and injury prevention in the elderly

True or False

A

True

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22
Q

What scale can be used as a criteria for falls

A

Berg Balance Scale

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23
Q

OA is common in what demographic?

A

older adults

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24
Q

Most commonly affected parts in OA? (2)

A

hands and knees

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25
Q

What part of the body causes the most significant amount of pain in OA? (2)

A

Hips & spine

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26
Q

______ can lead to ______ which can cause nerve root impingement

A

Disc desiccation

spinal stenosis

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27
Q

Risk factors for OA: (4)

A

obesity, genetics, inadequate nutritional content, muscle strength

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28
Q

osteopenia and OA is more common in what demographic?

A

postmenopausal women

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29
Q

osteopenia and OA leads to increased risk for [] leading to pain, immobility, and functional dependence

A

fractures

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30
Q

Osteopenia bone mineral density score:

A

-1.0 and -2.5

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31
Q

Osteoporosis bone mineral density T score

A

≤ -2.5

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32
Q

Risk Factors for osteopenia and OA: (4)

A

increasing age, family hx, glucocorticoid therapy, smoking

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33
Q

Hip Fractures are more common in older or younger people?

A

older adults

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34
Q

T/F: Hip fractures are associated with increased mobility, mortality, and health care use and cost

A

True

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35
Q

T/F: Hip fx result in long-term disability and increased functional dependence

A

True

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36
Q

Risk factors for Hip fx: (4)

A

falls, associated risks of falls, osteoporosis, skeletal fragility

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37
Q

T/F: Rehab should emphasize weight bearing as soon as possible with goals of pain control & early loading while avoiding fracture dislocation & implant failure

A

True

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38
Q

What is the leading cause of acute neurologic admissions to hospitals and death?

A

Stroke

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39
Q

T/F: Stroke health outcomes are worse among older adults because of age-related comorbids and frailty

A

True

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40
Q

Rehab for stroke begins in the acute or chronic setting?

A

acute setting

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41
Q

T/F: PT management in stroke includes: Strengthening, ROM, and spasticity management. Interventions for low-vision, cognitive, and urinary incontinence are outside our roles

A

False

42
Q

Risk factors for stroke: (6)

A

previous stroke, transient ischemic attack (TIA), HtN, hyperlipidemia, heart disease, DM

43
Q

What age has the highest incidence of hospitalizations and death d/t TBI?

A

> 75 y/o

44
Q

Which is a more common cause of TBI: MVA or falls?

A

falls

45
Q

TBI have better outcomes assoc. with increasing age

true or false?

A

False

poorer outcomes

46
Q

Risk factors for TBI: (2)

A
  1. physical and cognitive impairments
  2. Having multiple medical conditions & medications
47
Q

____ (2) increase risk for SCI

A

Loss of bone mass and changes in body composition

48
Q

Traumatic SCI is likely d/t ____

A

falls

49
Q

Nontraumatic SCI is attributable to _____ d/t ______ from ______

A

cervical or lumbar spinal stenosis

degenerative joint processes disc herniation, or mass effect

hematomasory tumor growth

50
Q

What year of survival in SCI is a good prognosis?

A

First-year

51
Q

Mortality rates increase dramatically with age

True or False

A

True

52
Q

Group of symptoms that affect the patient’s daily function

A

Dementia

53
Q

Symptoms of Dementia (5)

A

Executive cognitive dysfunction, memory impairment, mood, personality, and behavior changes

54
Q

Reversible vs. Irreversible cause of Dementia:

  1. SDH
  2. Alzheimer’s
  3. Parkinson’s
  4. Depression
  5. Hormonal Imbalances
A
  1. R
  2. I
  3. I
  4. R
  5. R
55
Q

Reversible vs. Irreversible cause of Dementia:

  1. Drug and alcohol abuse
  2. Huntington’s
  3. severe or repetitive TBIs
  4. Vit deficiency
  5. AIDS
  6. repeated neurovascular insults
A

All are irreversible except for 1 & 4

56
Q

Delayed identification is critical in dementia

True or False

A

False

Early identification

57
Q

What is a clinically identifiable precursor to Alzheimer’s Disease?

A

Mild cognitive impairment (MCI)

58
Q

Acute neurocognitive disorder that is transient & reversible

A

Delerium

59
Q

Delerium is reversible

True or False

A

True

60
Q

Delerium occurs more commonly among older or younger individuals?

A

older

61
Q

Diagnostic criteria for delerium:

○ Disturbance in [] and [] that develops over a short period of time and [] and [] during the course of the day
○ Disturbances in []
○ Disturbances in [] and [] are not
better explained by a pre-existing neurocognitive
disorder
○ Evidence that the disturbance is directly d/t a
pathophysiologic process such as [] or drug-related []

A
  1. Disturbance in attention and awareness that develops over a short period of time and waxes and wanes during the course of the day
  2. Disturbances in cognition
  3. Disturbances in attention and cognition are not better explained by a pre-existing neurocognitive disorder
  4. Evidence that the disturbance is directly d/t a pathophysiologic process such as a medical condition or drug-related toxicity
62
Q

PTs cant treat individuals c delerium

True or False

A

True

Treatment is pharmacologic & should be referred back to MD

63
Q

Cause of normal pressure hydrocephalus

A

Idiopathic or related to previous meningitis or subarachnoid (SA) hemorrhage

64
Q

Hallmark signs of normal pressure hydrocephalus: [], [] disturbance, [] along with ventriculomegaly with [] CSF pressures

A

dementia, gait disturbance, urinary incontinence along with ventriculomegaly with normal CSF pressures

65
Q

Ataxia is not present in normal pressure hydrocephalus

True or False

A

False

66
Q

What do you call the gait in severe normal pressure hydrocephalus

A

Magnetic gait

67
Q

Progressive neurodegenerative disorder with Ataxia, bradykinesia, tremor, cog-wheel rigidity

A

Parkinsons Disease

68
Q

type of rigidity in Parkinsons

A

cog-wheel

69
Q

Parkinsons pts do not usually have dementia

True or False

A

False

May have dementia

70
Q

What type of tremor is present in Parkinsons?

What can worsen this tremor?

A

Resting tremor increases with stress

71
Q

Type of gait seen in Parkinsons

A

Parkinsonian gait (can be Festinating)

72
Q

Results to positive effects of strength & function for mild to moderate PD

A

Resistance training

73
Q

Amputation is attributable to what?

A

vascular disease

74
Q

Life expectancy is shorter after amputation

True or False

A

True

75
Q

Prognosis for successful prosthetic rehabilitation is influenced by what?

A

number and type of comorbidities

76
Q

Increased energy demands in amputation result in better outcomes

True or False

A

False

Increased energy demands in amputation result in poor outcomes

77
Q

Amputation c comorbid respiratory disease affects _____

A

gait retraining

78
Q

End Stage Renal Disease (ESRD), miss rehab schedule d/t ____ and frequently affect _____

A

dialysis commitments

limb volume

79
Q

_____ is a more important predictor of successful prosthetic rehab

A

Premorbid function

80
Q

The remaining limbs will perform the function; _____ (increase or decrease) energy expenditure causing _____

A

increase

higher physiologic demands

81
Q

Not all skills will increase p amputation

True or False

A

True

82
Q

_____ miss rehab schedules d/t dialysis commitments and frequently affect _____

A

End-Stage Renal Disease (ESRD)

limb volume

83
Q

Cancer is more prevalent at what age?

A

> 65 y/o

84
Q

Prevalence of cancer increases with increasing elderly population

True or False

A

True

85
Q

Cancer treatment considerations: (3)

A

Comorbidities and cognitive/functional status, cancer type

86
Q

Multiple comorbidities increase the likelihood of death d/t cancer related causes

True or False

A

False

d/t non-cancer related causes

87
Q

Effects of treatment may compete with the patient’s interest and wishes

True or False

A

True

88
Q

Moderate physical activity, ___ mins/week decreases ___ by __% among breast CA survivors & __% among colorectal CA survivors

A

150

total mortality risk

24

28

89
Q

Use of multiple drugs

A

polypharmacy

90
Q

Causes adverse drug reactions from multiple drug regimens

A

polypharmacy

91
Q

Common ADRs of polypharmacy include: (7)

A

dizziness, insomnia, confusion, sedation, nausea, changes in bowel habits, balance problems

92
Q

Medication side effects can be confused as ____ in polypharmacy

A

symptoms of a new illness

93
Q

“The prescribing cascade”

A

polypharmacy

94
Q

polypharmacy increases the risk for: (2)

A

falls & delirium

95
Q

What are the 8 management issues?

A

Medication management
Pain management
Nutrition
Physical exercise
Ambulatory assistive devices
Orthoses & footwear
Psychosocial support
Modifying the environment

96
Q

ACTIVITY RECOMMENDATIONS IN OLDER ADULTS WITH NO LIMITATIONS:

Moderate-intensity aerobic activity: enough to result in noticeably increased heart rate and breathing, for at least ___ minutes ___ days a week.

A

30

5

97
Q

ACTIVITY RECOMMENDATIONS IN OLDER ADULTS WITH NO LIMITATIONS:

Resistance training (calisthenics, weight training): at least one set of ____ repetitions of an exercise that trains the major muscle groups on ____ nonconsecutive days each week.

A

10 to 15

2 or 3

98
Q

Resistance training of at least one set of 10 to 15 repetitions of an exercise that trains the major muscle groups can be done on 2 or 3 consecutive days each week.

True or False

A

False

non-consecutive days

99
Q

ACTIVITY RECOMMENDATIONS IN OLDER ADULTS WITH NO LIMITATIONS:

Flexibility: at least ____ minutes of stretching major muscle and tendon groups at least ___ days each week; ____ seconds of ____ stretches and ____ repetitions for each stretch. Ideally performed every day that aerobic and resistance training is performed.

A

10

2

10 to 30

static

three to four

100
Q

ACTIVITY RECOMMENDATIONS IN OLDER ADULTS WITH NO LIMITATIONS:

Balance exercise ____ times a week (ideal type, frequency, and duration has not been defined)

A

three

(3) PT in Special Conditions (40 decks)

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