Falls Flashcards
how is vision affected as we age
Smaller pupils, lens thickening = less light
how is central processing and cognition affected as we age
reduced reaction time
how is peripheral sensation and proprioception affected as we age
increased postural sway
poor sensory awareness
how are falls classified
Intrinsic or extrinsic
Explained or unexplained
Injurious or non-injurious
Accidental or non-accidental
Syncopal or non-syncopal
what are intrinsic risk factors
CV - dizziness, arrhytmias, heart disease
MSK - joint pain, arthritis, sarcopenia
Neuro - Parkinsonism, stroke, neuropathy
Vision - decreased visual acuity, depth perception and contrast sensitivity
Other - low BMI/malnourished, depression, cognitive impairment
what is the definition of orthostatic hypotension
Fall in SBP >20 mmHg or
Fall in DBP >10 mmHg after 3 minutes of standing
what are extrinsic risk factors
Medication Alcohol Environmental obstacles Poor lighting Inappropriate clothing/footwear Inappropriate walking aids
what should be asked to screen for falls
- Have you had 2 or more falls in last 12 months?
- Have you presented acutely with a fall?
- Do you have problems with walking or balance?
why is cognitive impairment a risk factor for falls
impairs:
- judgement
- visual-spatial perception
- orientation
how is BPPV diagnosed
Hallpike manoeuvre
how is BPPV treated
Epley manoeuvre
what drugs increase risk of falls
Benzodiazepines Neuroleptics Antihypertensives Antidepressants Anticholinergics Class 1A antiarrthymics
what tools can be used to assess people after a fall
Timed up and go test (TUG)
Berg Balance test
Tinetti Score
Tx post falls
Strength and balance training
Environmental modifications
Medication review
