Geriatric: Prevention & health maintenance Flashcards
T/F Functional decline & loss of independence are NOT an INEVITABLE consequence of aging
T
Primary prevention =
Stop disease development
* Immunizations
* Lifestyle modifications
–Smoking cessation, seatbelt use, & physical
activity
* Chemoprophylaxis
–Statins for primary prevention of heart disease
Physical activity screening
Physical Activity Assessment
Physical Activity
Effective Exercise
- Specific → To improve sit to stand, practice sit to stand
- Overload → Change in tissue requires novel stress
- Progression → ↑ the overload based on response
- Recovery → Rest x time = tissue healing & reponse to stress
Heavy resistance training at retirement age induces _____
4-year lasting beneficial effects in muscle strength
Physical Activity
Tai Chi benefits
- ↓ falls by 58% compared to stretching or multimodal exercise
- ↑ walking speed & physical function
- ↑balance confidence
- Economical
Tobacco Cessation USPSTF Grade:
A
T/F A patient is NEVER too old to benefit
from smoking cessation
T
Risk factors among older adults for increased alcohol consumption
Bereavement, depression, anxiety, pain, disability, prior history of alcohol use
CAGE questions
- Cut Down
- Annoyed
- Guilty
- Eye opener
Immunizations in older adults
- Tetanus (Td)
– q 10 years for adults - Tdap
– 1 dose 19+ years–old
adults - Influenza
– q year - Pneumonia
– PCV13 at 65 years,
then
– PPSV23 1 year later - Herpes Zoster
– 2 doses 50+ yo
– 2-6 mo. apart
– 1 dose ≥60 yo
Early detection & treatment of asymptomatic disease
– Screening for cancer (Eg-mammograms)
– Hearing or vision impairment
– Osteoporosis
– Hypertension
– Abdominal aortic aneurysm (AAA)
– ASA for further cardiac arrest
Screening options for colorectal cancer
- Guaiac fecal occult blood test
– Annual - Immunochemical fecal occult
blood test (FIT)
– Annual - Flexible Sigmoidoscopy
– q 5 yr
Strong recommendation to screen men aged 35+ for _____
Lipid screening
______% pts w/ hip fracture die within 1 year
21 - 30
Clinical manifestations & risk factors for osteoporosis screening in men
– Hx of low trauma fx
– Radiographic osteopenia
– Loss >1.5 inches height
– Long-term glucocorticoids
– Androgen deprivation
– Hypogonadism
– Primary hyperparathyroidism
– Hyperthyroidism
– Some intestinal disorders
Tertiary Prevention
- Tertiary prevention identifies established conditions
to prevent further morbidity or functional decline - Hospital admission
– Usually for serious or life-threatening problem
– Less serious disorders that cannot be adequately
treated in another place
– Condition specific criteria
Main goal of hospitalization =
Restore or improve health so that
people can return home
Hospitalization among Geriatric Patients
- Cardiac Arrhythmias
- CHF
- COPD
- Coronary Atherosclerosis
- Diabetes
- Medication Complications
- Infection
– Eg Pneumonia & Urosepsis - Stroke
Preventing readmission: Modifiable factors
– Premature discharge
– Inadequate post- discharge support
– Insufficient follow-up
– Therapeutic errors
– Adverse drug events & other medication related issues
– Failed handoffs
– Post-procedures complications
– Nosocomial infections, pressure ulcers, & patient falls
Harms of driving cessation
- Adults who stop driving have ↑ rates of depression
- Shrinking world syndrome
– loss of driving ability leads to ↓ living space - Ripple effects
– Who else is affected when someone stops driving?
Driving History in older drivers
- How far do you drive each year?
- Where do you drive (local v. distant, familiar v. new places)?
- Have you had any car accidents or tickets recently?
– ~1 accident per 8-9 near misses - Have you ever gotten lost while driving?
Driving History of older drivers For family members:
– Do you ever drive with the patient?
– Are you scared to drive with them?
– Would you let your child ride with them?
– Most children will wait 2 years before bring up the
subject
Driving Assessment 4 C’s:
– Crash history
– Family Concerns
– Clinical condition
– Cognitive function
