Geriatric Health Flashcards
Geriatric Giants
Cognitive Disorders:(Dementia/Delirium)
– Polypharmacy
– Falls/Gait Instability
– Urinary Incontinence
– Depression
– Malnutritio
Basic activities of
daily living
(BADLs)
Feeding.
Bathing
Dressing
Continence
Toileting
Transfers
Instrumental
activities
of daily living
(IADLs).
Managing
money.I
Taking
medications
Shopping,
_
Preparing
food.
Using
telephone
Transportation
Most Common Problems in the
Elderly
Weight Loss
• Falls
• Hearing Disorders
• Eye Disorders
• Urinary Incontinence
• Polypharmacy
the most
important anthropometrics parameters
Weight
Bmi
Screening for weight loss
1.Body mass index (BMI).
2. Weight loss in past 3 months >2 kg
3. Acute illness or major stress in past 3 months?
4. Mobility
5. Dementia or depression
6. Has appetite & food intake declined in past 3 months?
Risk factors for falls include:
Vision impairment
■ Muscle weakness
■ Peripheral neuropathy
■ Medication
Fall test
Timed get up and go test
o Rise from sitting position
o Walk 10 feet
o Turn around
o Return to chair and sit down
Patient who takes <20 seconds to complete test, this denote that he is independent in mobility. While patient who requires >30 seconds to complete test suggests higher dependence and risk of falls.
Hearing impairment eg
Presbycusis
Occurs in the high frequency range & it is bilateral
■ Noise induced hearing loss
■ Cerumen impaction
Screening of hearing
impairment
Inspect ear for impacted cerumen.
• Whisper voice ,finger rub test .
Done by whispering 3 – 6 words at a distance of 12, or 24 inches from the
patient’s ear
• Audioscope
Inability to hear 40 decibles tone at 1000 or 2000 Hz in one or both ears
implies failed hearing
Family Medicine D
used to screen for visual
deficits.
Family Medicine Department
Snell chart
trickling of urine
Overflow
involuntary
urine loss
intra-abdominal pressure
Stress incontinence
strong urge
to
pass urine.
Overactive bladder
inability to reach
toileting facilitie
Funtional incontenice
Dementia
acquired progressive impairment in multiple
domains of cognitive functioning (memory plus at least 1
other)
Cognitive Screening
Clock Drawing Test &
The Mini-Cog
The Folstein Mini-mental State Examination
The Mini-Cog : clock drawing test
3 item recall: give 3 items, ask to
repeat, divert and recall
Abnormal Mini-Cog scoring with best performance
• Recall =0, or
• Recall ≤2 AND CDT abnormal
The most critical step for clinicians is the
integration of the obtained data.
Primary Prevention
Encourage Physical Activity and counsel against Alcohol and Tobacco
• Discuss prophylactic Aspirin in CV Risk assessment
Immunizations
• Influenza – Annually
• Pneumococcal
• Herpes Zoster
• DT
Secondary Prevention
Early detection and treatment of asymptomatic disease
Cancer Screenings
• Colorectal
Blood Pressure Screening
• Lipid Screening
• Osteoporosis (DEXA)
• Abdominal Aortic Aneurysms
• Breast cancer
• Cervical cancer
• Lung cancer
Screening for poly Pharmacy duration
Annually
Screening for incontinence
Two questions
In the past year, have you ever lost urinr in the getting wet?
Have you lost your urine on at least six separate days?
Depression is screening for geriatric
Geriatric depression skill+ phq2
Geriatric vaccinations
Influenza tetanus every 10 years diphteria
Osteoporosis screening
Dexa for women with age 65 years or older or. Younger with risk of fractures.
Decline in function and loss of independence are ————-consequence of aging
Not invevitable
Persons unable to perform iadls more likely to
Dementia
Impairment in ADL result in
Hip fracture
Falls
Depression
Malnutrition screening
Serial weight measurments
Changing apepetite
Mini nuttritional assessment
Leading cause of injuries in eldrely
Falls
Leading cause of death from injuries
Comp associated with falls
Functional impairment precersour
Hip fractures
In vsioin screening for elderly ,, referals are
Routinnnnnnne bec visual acuity don’t spot glucoma
Presbycusis def
Bilat sensrineuring hearing loss slective high frequency and difficult speech discrimination
The most common form of hearing loss in elderly
Presbycusis
What to do if patient fail mini cog test
Folsteien mini mental state
Caccines of old age
Influenza
Anuaaly
Tetanus diphteria every 10 years
Pneumococcal
Herpes zoster
