Older adults

Question 1

Describe some of the issues that are important for looking after older people in primary care

Answer 1

Communication issues
Multiple co-morbidities
Frailty
Side effects of medication
Polypharmacy
Social barriers
Cognitive impairment
Reluctance towards medication

Question 2

Describe approaches to prevent falls and fractures among older people

Answer 2

Risk assessment

Treat osteoporosis

Question 3

Risk factors for osteoporotic fractures in older age

Answer 3

Age
Female sex (esp. early menopause)
GI disease (e.g. Coeliac, Crohn’s)
Immobilization
Chronic kidney disease
Calcium deficiency (diet)
Vitamin D insufficiency (diet / sunlight / genetic)
Drugs – esp. steroids, alcohol abuse, smoking
Low BMI (≤ 19kg/m2)
Endocrine diseases – Cushings, diabetes, hyperthyroidism, hyperparathyroidism
Previous fragility fracture

Question 4

Interventions for preventing falls in older people

Answer 4

Strength and balance training (physio)
Exercise in extended care settings (physio)
Home hazard and safety intervention (OT)
Vision assessment and referral (optician)
Medication review (GP)
Treat underlying medical causes (GP)
Consider referral to specialist falls clinic (GP)