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GE 80B MID 1 > All > Flashcards

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1
Q

What is the hospitalization rate for 65+,85+?

A

3x, 6.9x

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2
Q

Most common chronic condition

A

Hypertension, arthritis, heart disease, cancer, diabetes, asthma, COPD

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3
Q

What percent of doctors are geriatricians?

A

3-6%

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4
Q

What is the need for geriatricians?

A

Currently have 8,000, need 14,000, in future we will need 36,000

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5
Q

Assessment of the elderly patient

A

Medical, cognitive, affective-mood, functional (physical, social), economic, caregiver, environmental, quality of life/well being, advance directives - what do they want to do at the end of their lives, spirituality

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6
Q

ADL

A

Bathing, dressing, continence, feeding

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7
Q

Intermediate Activities of Daily Living

A

Using telephone, preparing meals, shopping, housekeeping, doing laundry, taking medicine, handling finances

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8
Q

Advanced activities of daily living

A

Recreational, occupational, community service

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9
Q

Life space diary

A

As you get older, your range of life gets smaller, first you can’t go outside the county and then later outside of your home

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10
Q

What 5 aspects define frailty?

A 
3/5 must be met:
SWULC
Unintended weight loss
Weak grip strength
Slow waking speed
Low physical activity 
Chronic exhaustion
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11
Q

Do more males or females over 65 show problems with ADL or IADL

A

half as many males show problems than females

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12
Q

Leading cause of injury and injury related death

A

FALLS, 30% experience a fall in a given year

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13
Q

What are risk for falls?

A

sarcopenia, arthritis, impaired gait, use of 4+ meds which can affect blood pressure and balance, drugs for anxiety,depression or pain, visual impairment
Unlike other health problems fall related deaths have increased since 1990

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14
Q

normal eye changes

A

Cornea protects eye from dust and gets thicker thus reducing pupil size, vitreous fluid in the eye can get cloudy, can’t focus of adjust from light to dark as easily, decreased depth perception, impaired night vision because of small pupil, glare as cornea thickens, presbyopia

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15
Q

Lens

A

Focuses light to the optic nerve, major changes occur here, oldest cells in the body, collagen becomes less elastic, muscles that stretch the lens deteriorate

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16
Q

Accommodation

A

Changing lens to see far and near

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17
Q

Retina

A

Center is macula
Cones- color and detail
Rods - general shape

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18
Q

Presbyopia

A

Far sided, can’t see things near normal part of aging

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19
Q

cataracts

A

Leading cause of reversible blindness, collagen becomes cloudy and old, most commonly paid for Medicare surgery - lens removed and replaced with artificial lens

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20
Q

glaucoma

A

tunnel vision, fluid buildup causes pressure on optic nerve, leading cause of irreversible blindness in US, fluid can’t drain from canal of Schlemm

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21
Q

macular degeneration

A

can only see the sides not the middle, no cure but can slow progression

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22
Q

dry macular degeneration

A

Changes in cells that should transmit nutrient to macula, more common

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23
Q

wet macular degeneration

A

blood vessels begin to form near the macula which interfere with nutrition

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24
Q

Hearing loss

A

Presbycusis- normal aging, 33% have hearing loss, men at more risk than women, fluid in cochlea also affects balance

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25
Q

Anosmia

A

olfactory bulb closes to hippocampus early sign of AD, normal aging

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26
Q

Eating and age

A

lower muscle tone in pharynx causes difficultly in swallowing, constipation, lower mobility makes it harder to cook and buy food

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27
Q

Gut microbiome

A

over 160 species of bacteria in gut, as we age there is variability in the number of them in the gut, they boost immunity and help breaks down food

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28
Q

Touch

A

decrease in touch receptors, decrease in pressure receptors, decrease in ability to manipulate small objects

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29
Q

balance and equilibrium

A

vestibular, peripheral, visual

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30
Q

Tai chi

A

augments immunity

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31
Q

sensation

A

process of taking in info through the sense organs

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32
Q

perception

A

info is processed in the brain

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33
Q

sensory threshold

A

minimum intensity of a stimulus for an individual to detect a stimulus

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34
Q

Recognition threshold

A

intensity of a stimulus needed for an individual to recognize it

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35
Q

sensory discrimination

A

min difference necessary between one or more stimuli in order for a person to distinguish between them

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36
Q

Cornea eye changes

A

first to be affected, surface thickens, blood vessels become more prominent, rounded surface becomes flatter

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37
Q

Arcus senilis

A

fatty yellow ring forming around cornea but had no impact or indication of vision loss

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38
Q

Pupil

A

pupil opening decreases 2/3 in size, doesn’t seem to contract more in bright light and becoming bigger in low light

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39
Q

Retina

A

Slower shift between rods and cones, older adults show slower adjusting to changes in light

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40
Q

Lens

A

GREATEST Changes, mainly made of oldest cells of protein of collagen which hardens and becomes less flexible making accommodation hard, become more opaque.

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41
Q

What percent of people are 65+ in Florida?

A

18%

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42
Q

Age related macular degeneration

A

Elevator muscles that move the eyeball up and down and ciliary muscles which change lens shape deteriorate with age, gene affected is hemicentlin 1

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43
Q

cochlea

A

Hair cells that vibrate to move sounds waves, vibration causes frequency or pitch, and intensity causes loudness

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44
Q

osteosclerosis in the ear

A

stapes becomes fixed and cannot vibrate

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45
Q

tinnitus

A

High pitched ringing

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46
Q

Olfactory hedonic experiences

A

odor stimuli evaluated emotionally rather than analytically

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47
Q

Robust vs non robust older adults

A
  1. Productive involvement (1500+ hours com service, home maintenance)
  2. No depressive symptoms
  3. High physical functioning
  4. No cognitive impairment
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48
Q

What qualities predict positive aging?

A
  1. Long term relationships in which older adults help others and accept help
  2. Supportive marriage or partnership
  3. Continued involvement in life, making new friends, accepting inevitability of death
  4. Mature defense mechanisms and coping response rather than passive acceptance when dealing with crises in health or relationships
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49
Q

Spirituality

A

Transcnedning body space ego and time, giving and receding support, intuitive understanding of how to cope with life

50
Q

Volunteerism rates highest in

A

Middle age 34-44

51
Q

Political participation

A

Voting difference greater within than between age groups

52
Q

Wheel of civic engagement

A

Deliberative dialogue, service learning, internships, community service, volunteerism, community partnership, community based research, get out the vote initiatives, activism

53
Q

Nine categories of civic health index

A

connecting to civic and religious groups, trusting other people, connecting to others through family and friends, giving and volunteering, staying informed, understanding civic and politics, participating in politics, trusting and feeling connected to major institutions, expressing political views

54
Q

Civic engagement over time

A

Decline in civic engagement over time since 1960s

55
Q

Demographic changes affecting civic engagement

A

Urban sprawl commuting reduces involvement, fewer marriages, more divorces, fewer children, lower wages

56
Q

Charitable giving

A

Has remained fairly constant

57
Q

Volunteering

A

To increase among this generation

58
Q

Robert Puttnam on diversity

A 
Diversity is good and bad 
Good for long term
Why good?
Religion, army 
Why bad?
People feel more inclined to volunteer for shared racial identity
59
Q

Leading cause of death for all ages

A

Heart disease

60
Q

Leading cause of death in the US for 15-24, also 1-44 age group

A

Unintentional injuries

61
Q

Most potential years of life lost before 65

A

Due to unintentional injury

62
Q

Leading causes of injury death

A 
#1 poisoning/overdose 
#2 motor vehicle crash
#3 falls
63
Q

Ecologic model

A

helps to contextualize both risk factors and interventions

Individual –> relationship –> community –> societal

64
Q

Mvc preventative strategies

A

Graduated listening, insurance rates, max speed limits, seat belt laws, child safety Seats, cell phone/texting bans

Environmental/structural
Air bags, crash barrels, speed trailers, runaway lanes

65
Q

Most effective fall prevention

A

Comprehensive clinical assessment combined with individuals risk reduction and patient follow up

66
Q

Public Health Approach of Injury

A
  1. Define the problem through surveillance
  2. Identify risk and protective factors
  3. Develop test prevention strategies
  4. Assure widespread adoption of effective injury prevention principles and strategies (i.e.: minimum age drinking laws)
67
Q

Healthy People 2010

A

set of disease prevention and health promotion objectives for the nation to achieve in the first decade to eliminate health disparities

68
Q

Motor vehicle related injury

A

Twice in men than in women older adults

69
Q

Older adults drivers

A

Less likely to be involved in crash that kills so

70
Q

KATZ scale and Burge Balance scale

A

Study

71
Q

Brain health is…

A

Involves thinking, attention, memory, relaxation, mood, physical activity

72
Q

Anti inflammatory lifestyle strategies

A

Good night sleep, eating omega 3 fatty acids, physical exercise

73
Q

AD

A

Amyloid plaques and tau tangles that were later found to be the same plaques that cause senility, age is the single greatest risk factor, sensory motor and visual cortex spared or damage so ppl can sense and see things but cannot interpret them

74
Q

apolipoprotein E-4

A

Common allele in 20% of population that increased risk but some with it never get AD, some without it get AD So not a good predictor

75
Q

Other genes that indicate AD

A

Presenilin genes and APP gene

76
Q

Functional mri scans of AD patients

A

Show more functioning in patients at risk for AD because they are overcompensating

77
Q

Memory

A

Learning, recall

78
Q

Cognition

A

Memory, attention, visual/spatial skills, reasoning

79
Q

Dementia

A

Memory loss + another impairment

80
Q

Cognitive disorders in older adults

A

Alzheimer’s, vascular disease, lest body disease, Parkinson’s, hunting tons, frontal dementia, head injury, nutritional, medications, alcohol/toxins, infectious, depression, neoplasms, autoimmune disorders

81
Q

Non genetic risk factors of dementia

A

Physical conditioning, mental stimulation, stress management, nutrition

82
Q

Hippocampus growth

A

Exercise grows the hippocampus

83
Q

Obesity and memory

A

Obesity increase memory loss and weight loss decrease memory loss

84
Q

Brain protective drinks

A

Red wine (reservatrol), caffeine, any alcohol in consideration, pomegranate, turmeric

85
Q

AD prevention strategies

A

Physical exercise and healthy diet

86
Q

Cognitive functioning

A

Intelligence, learning, memory

87
Q

Tests of multidimensional structure of intelligence - primary mental abilities

A

Mathematical reasoning, word fluency-use of appropriate words to describe the world, spatial relations, inductive reasoning - generalize facts to concepts/logic, verbal memory - retain/recall words from reading, perceptual speed, verbal meaning - vocabulary

88
Q

Fluid intelligence

A 
Biologically determined, independent of experience, "native intelligence" 
Spatial orientation
Abstract reasoning 
Word fluency
Inductive reasoning
89
Q

crystallized intelligence

A 
acquired through education and experience, social judgement,
Word association
Social judgement 
Number skills 
Verbal meaning
90
Q

Most widely used intelligence test

A

WAIS - wechsler adult intelligence scale
6 verbal scales - crystallized Intel
5 performance scales - fluid Intel

91
Q

Classical aging pattern

A

Decline with age in performance scales (fluid) stable with age in verbal scales (crystallized)

92
Q

Problems in cognition functioning tests

A

Cross sectional studies, cohort being more important than age difference, subject attrition, selective attrition producing skewed studies

93
Q

Gender differences

A

Men slow down in areas of spatial awareness first and women slow down in word fluency first women have a late Peale performance

94
Q

Terminal decline hypothesis

A

Rapid decline in Intel in the last 5 years of life

Proximity to death is more indicative of intellectual decline than age

95
Q

executive function

A

Ability to organize ones learning and plan and make decisions and to shift attention to modify cognitive and spatial sets as new info is received
Leads to decline in IADLS

96
Q

Three components of attention

A

Selective attention - learner must be able to reject irrelevant information
vigilance - requires to look out for a signal or specific stimuli
attentional control - individuals ability to determine how much attention should be given to a stimuli in conditions of divided attention

97
Q

General slowing hypothesis

A

processing of info slows down in the nervous system with age

98
Q

recall

A

process of searching through vast store of secondary info perhaps without an orienting question (free response answer)

99
Q

recognition

A

requires less search, matching with orienting question (MC)

100
Q

Decrement model

A

Memory networks deteriorate with age

101
Q

Incremental knowledge gain

A

all the knowledge and vocab gathered by older adults can cause more names in secondary meme key to interfere with the name to be recalled

102
Q

Memory mediators

A

Use of Visual and verbal links between info to be encoded and that in secondary memory

103
Q

Visual mediators

A

Associating word with locations

104
Q

Look snap connect

A

Look

105
Q

Cognitive plasticity

A

Ability to accomplish three mechanisms which are selection optimization and compensation

106
Q

Neural plasticity

A

Changes in brain structure and function that result from new neuron and synaptic connections

107
Q

Dementia

A

Loss of:
Coherent speech
Recognizing or identifying objects
Executing and comprehending motor tasks
Thinking abstractly and performing executing functions
Change in ability to recall events in current memory
Disorientation in time place and person

108
Q

Beginning stage of a AD

A

First affected area is the hippocampus which aids in learning new info and retrieving old info

109
Q

Intermediate stage of AD

A

Once neocortex is affected more complex thinking like linking old info with new info are affected

110
Q

Advanced age of AD

A

Neurons affected in motor cortex

111
Q

Tests for AD

A

Mini cog - shorter

Mini mental status exam, dementia rating scale

112
Q

Global deterioration scale

A
  1. No cog/functional decrements
  2. Complaints of mild forgetfulness
  3. Mild cog impairment, concentration problems, difficulty traveling alone
  4. Confusional stage, planning, handling finances
  5. Poor recall of events, need to be reminded of ADL
  6. Advanced memory decline, need assistance with ADL, personality changes
  7. Loss of verbal abilities, incontinence, can’t walk, may become comatose
113
Q

Five outcome areas of service learning

A

Attitudes toward self, attitudes toward learning, civic engagement, social skills, academic performance (most salient)

114
Q

K-12 service learning standards what 4 recommend practices studied

A

Linking progress to academic and program objective and curriculum,
Incorporating youth voice, involving community partners, providing opportunities for reflection

115
Q

Results of service learning meta analysis

A

Programs that used recommended practices yielded twice the positive effect of programs that didn’t use recommended practices, outcome comparable regardless of age, number of recommendations didn’t really Matter

116
Q

How many people on LA city council? Asians? Women? County board of supervisors?

A

15,1,1, 5

117
Q

The third LA

A

1st - 1880s to before WW2, lots of growth but walkable downtown streetcar system
2nd - WW2 to turn of the millennium, freeways, suburbs
3RD - Profound reinvention - no more room to sprawl, dense housing, mass transit

118
Q

Good deserts

A

Lots of LA areas don’t have grocery stores

119
Q

Gerotechnology

A

Technology to help older people to engineering to make assistive technology

120
Q

Universal design

A

Signing the environment to accommodate both young and old health and disabled

121
Q

Telemedicine

A

Providing care from a distance, transmission of data to improve healthcare

122
Q

Most common chronic conditions in older adults

A

Hypertension, arthritis, heart disease

GE 80B MID 1 (1 decks)

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