Falls

Question 1

What physiological things that happen as we age lead to falls?

Answer 1

decreased light due to smaller pupils and lense thickening
sarcopenia
decreased reaction time (due to decreased cognition)
decreased cardiorespiratory fitness
decreased peripheral sensation and proprioception
increased postural sway

Question 2

What defines postural hypotension?

Answer 2

fall in SBP >20
DBP >10
after 3 mins of standing

Question 3

What is syncope often due to?

Answer 3

arrythmias
postural hypotension
vasovagal
carotid sinus hypersensitivity
vavlular heart disease

Question 4

What medications commonly increase falls risk?

Answer 4

POLYPHARMACY
benzodiazepines
neurepileptics
antihypertensives
antidepressants
anticholinergics
class 1a antiarrythmics

Question 5

How are falls investigated?

Answer 5

timed up and go test
lying vs standing BP
Berg balance test
Tinetti score

Question 6

How do you measure a lying vs standing BP?

Answer 6

1st BP taken after lying for at least 5 mins
2nd BP taken after standing in the first minute
3rd BP takn after standing for 3 minutes

Question 7

How do you reduce falls risk?

Answer 7

strength and balance training 3x a week for 12 weeks = tai chi is good
stop polypharmacy
start calcium/vit D
manage postural hypotension