Falls Elderly Flashcards
Why are falls an issue
Because they are so common
high cause of morbidity and mortality
Outcomes of fall
Injury Loss confidence Dependency Decreased QOL Terminal decline Institutionalisation
RF for falls
Muscle weakness History falls Gait deficit Visual deficit Arthritis Depression Age
Intrinsic factors that contribute to falls
Gait and balance Syncope (cardiac, vagal) Chronic disease visual problems acute illness cognitive disorder
Which situational factors can lead to falls
Medications (e.f diuretics, anti-hypertensives)
Alcohol
Urgency micturition
Extrinsic factors that can lead to falls
Inappropriate footwear
Environmental (uneven pavements, walking aids)
Poor lighting
What is a vasovagal syncope
Common faint
Cause of syncope
Neurally mediated
Orthostatic
Cardiac arrhythmia
Structural cardiac or cardiopulmonary disease
Management of patient who has had a transient loss of consciousness
History from patient Collateral Hx Examination (including lying and standing BP) 12 lead ECG Assess for red flags Consider further tests
What may show up on ECG
Long QT
Abnormal T wave inversion
Inappropriate persistent bradycardia
Red Flags Syncope
ECG abnormality HF Onset with exertion FH of sudden cardiac death New or unexplained dyspnoea Heart murmur
What is off legs usually associated with
Delirium
What cognitive disorders can commonly cause falls
Dementia
Delirium
Depression
Which medications could contribute to falls
Antidepressants Anti-psychotics Benzodiazepines Anti-hypertensives Diuretics
Which scores can assess osteoporosis risk
FRAX
QFracture
