Geriatrics

Question 1

Ageism is associated with

Answer 1

-Earlier death (7.5 years)
-Poorer physical and mental health
-Poor health behaviors

Question 2

What percentage of grandparents live with and provide for a grandchild?

Answer 2

30%

Question 3

In 2020, people 65+ comprised what % of the population?

Answer 3

20%

Question 4

Ratio of women to men ages 65-74

Answer 4

100:86

Question 5

What % of people 85+ live in long term care facilities?

Answer 5

15%

Question 6

Successful aging includes

Answer 6

-Low risk of disease and de-conditioning
-High cognitive and physical function
-Active engagement with life

Question 7

Optimal Aging

Answer 7

The capacity to function across many domains (physical, functional, cognitive, emotional, social, spiritual) to one’s satisfaction and in spite of medical conditions

Question 8

Primary aging

Answer 8

Inevitable, affects all systems

Question 9

Secondary aging

Answer 9

Lifestyle, environment, disease

Question 10

Factors that contribute to successful aging

Answer 10

-Physical Activity
-Lifestyle
-Sense of purpose
-Stress management
-Social networks
-Family support
-Sleep

Question 11

Atypical aging

Answer 11

May look like normal aging, but is due to underlying disease processes (cognition)

Question 12

How much muscle is lost per decade after 50?

Answer 12

12-15%

Question 13

Age of peak bone density

Answer 13

30

Question 14

Neuromuscular decreases

Answer 14

-Brain weight and volume
-Vascular supply and metabolism
-Nerve conduction and velocity

Question 15

Neuro red flags

Answer 15

-LOC
-Confusion
-Seizures
-Sudden bowel and bladder incontinence
-Sudden gait abnormalities

Question 16

1 cause of death in US

Answer 16

Heart disease

Question 17

Cardiopulmonary decreases

Answer 17

-VO2 max (10%/decade after 20)
-Cardiac output
-Blood vessel elasticity
-Pacemaker cells
-Chest wall compliance
-Lung capacity
-Heart cell walls thicken

Question 18

Oral changes

Answer 18

-Decreased saliva production
-Increased risk for swallowing issues

Question 19

Gut changes

Answer 19

-Altered digestive hormones
-Decreased stomach motility and peristalsis

Question 20

Overall GI changes

Answer 20

-Earlier satiety
-Impaired olfaction

Question 21

Presbyopia

Answer 21

-Far sighted
-Starts in middle age

Question 22

Decreased visual acuity

Answer 22

-More light needed
-Larger text

Question 23

Hardening and yellowing of lens

Answer 23

Difficulty distinguishing colors

Question 24

Cataracts

Answer 24

-Clouding of lens due to protein buildup
-Occurs in 70% of adults age 75

Question 25

Glaucoma

Answer 25

Loss of peripheral vision

Question 26

Macular degeneration

Answer 26

Loss of clarity at center of visual field

Question 27

Retinopathy

Answer 27

Damaged blood vessels in eyes

Question 28

Skin is how much of bodyweight?

Answer 28

15%

Question 29

Skin: fewer blood vessels, oil, sweat glands

Answer 29

Less thermoregulation and hydration

Question 30

Skin: decreased cell turnover

Answer 30

Increased healing time, decreased barrier function

Question 31

Skin: fewer mast cells

Answer 31

Increased risk of infection

Question 32

Less collagen and elastin

Answer 32

Thinner skin, wrinkles

Question 33

Cognitive aspects that remain stable with aging

Answer 33

-Long term memory and procedural memory -Retention of newly learned material (may require cueing to recall) -Visual recognition of objects

Question 34

Mild Cognitive Impairment Incidence

Answer 34

-Affects 19% of people 65-74 -Affects 38% of people 85+

Question 35

Mild Cognitive Impairment Definition

Answer 35

-Reduces the capabilities of a person compared to their respective age and education level, but does not interfere with ADL's -Gradual decline over 6+ months -Inverse relationship with education -Increases risk of Alzheimer's

Question 36

Dementia

Answer 36

Umbrella term for a collection of diseases that affect the brain

Question 37

Dementia affects

Answer 37

Thinking, behavior, ability to perform everyday tasks (ADL's)

Question 38

Dementia diagnostic criteria: two or more must be significantly impaired

Answer 38

-Memory -Communication and language -Ability to focus and pay attention -Reasoning and judgement -Visual perception

Question 39

Other conditions that may present as dementia

Answer 39

-Depression -UTI -Delirium -Medication side effects -Vitamin deficiency -Alcohol/drug abuse

Question 40

Delirium

Answer 40

-Sudden change in mental function -Often accompanied by decreased level of consciousness, slurred speech, agitation, hallucinations, emotional lability

Question 41

Causes of delirium

Answer 41

-UTI or infection -Dehydration -Hospitalization (11-42% of people) -Drug interactions

Question 42

Most common mental health condition in people 65+

Answer 42

Depression

Question 43

Depression incidence

Answer 43

-11-16% of overall older adult population -30-44% of people in communal living facilities

Question 44

Biggest contributing factors for depression

Answer 44

Loneliness, life events, transitions

Question 45

PHQ-2 Scoring

Answer 45

-3 or higher indicates likelihood of major depressive disorder -Should be further evaluated with PHQ-9

Question 46

Cancer incidence has increased how much in older adults over the past 30 years?

Answer 46

26%

Question 47

Increased chance of developing cancer as an older adult than a young person

Answer 47

11x

Question 48

Signs and symptoms of cancer

Answer 48

-Constant pain at night -Weight loss -Fever -Extreme fatigue -Back pain

Question 49

Underweight

Answer 49

-BMI less than 18.5 -Weakness -Slow gait speed -Low energy -Shrinking -Inactivity

Question 50

Frailness predictive of

Answer 50

-Falls -Hospitalization -Death -Disability

Question 51

Leading cause of long term disability

Answer 51

Stroke

Question 52

Strokes reduce mobility in what percent of stroke survivors over 65?

Answer 52

Half

Question 53

Stroke risk factors

Answer 53

-Age -High blood pressure -Diabetes -Smoking -High cholesterol -Heart disease

Question 54

Primary infection acquired in hospitals or long term care facilities?

Answer 54

UTI

Question 55

What percent of women 65+ have had a UTI within the last 12 months?

Answer 55

10%

Question 56

Signs and symptoms of UTI

Answer 56

-Fever -Flank pain -Hematuria -Change in mental and functional status (mimics dementia) -Report falling or loss of balance

Question 57

Primary older adults are how much more likely to have pneumonia and be hospitalized?

Answer 57

4x and 5x

Question 58

Second leading cause of hospital acquired infection?

Answer 58

Pneumonia

Question 59

Pneumonia occurs in what percent of hospital admissions?

Answer 59

8-10%

Question 60

Pneumonia leads to what % of all diagnosis of sepsis?

Answer 60

50%

Question 61

Pneumonia leads to what % mortality rate?

Answer 61

33%