Geriatric Syndromes Flashcards
Week 6
What is the definition of geriatric syndrome?
Term used to capture clinical conditions in older
individuals that do not fit into discrete categories
What are the key features of normal bladder control?
6-8 voids/day
0-2 voids/night
7-16 seconds duration
What are some changes in bladder control associated with aging?
sarcopenia involves pelvic floor muscles!
reduced sensation - may not feel the urge to urinate
reduced rate of urine flow from decreased strength of detrusor muscle
What is Benign Prostatic Hyperplasia?
a non-cancerous enlargement of the prostate gland
What are symptoms of Benign Prostatic Hyperplasia?
Frequent or urgent need to urinate
Waking up at night to urinate
Difficulty urinating
Leaking urine
Pain during urination or after ejaculation
Blood in the urine
What are symptoms of Lower Urinary Tract Dysfunction?
urgency and frequency (>8x/day)
feeling of incomplete emptying
nocturia
urinary incontinence
What is Urge Incontinence?
sensation of need to urinate followed by loss of urine
What is Stress Incontinence?
intermittent involuntary leakage of urine due to
abdominal pressure from effort/exertion or coughing,
sneezing, laughing
What is Mixed Incontinence?
involuntary loss of urine due to both stress and urge
What is Postural Incontinence?
involuntary loss of urine associated with change in
body position (sit to stand, supine to sit)
What is Functional Incontinence?
loss of urine related to impairments limiting
mobility, or dexterity in getting to the bathroom and proper
position to void
What are risk factors for LUTD or incontinence?
increased age
impaired cognitive function/dementia
bed rest
impaired mobility/locomotion
What is the relationship between incontience and falls?
Urge and Stress incontinence are positively associated with falls
larger the volume lost = greater risk of falls
positive correlation between higher TUG scores and symptoms of UI in 80y.o women
What is the impact of incontinence on rehab?
Slower functional gains
Increased rate of rehospitalization
Increased rates of institutionalization
What is “insidious sequelae” of ui?
Embarrassment
Stigmatization
Social isolation
Depression
Burden on caregivers
Decreased life satisfaction
What are some PT management techniques for UI?
Address mobility constraints
Work with PCP for pharmacologic contributions
Refer to pelvic floor specialist
bladder control strategies for sessions
What are the 4 steps for managing urgency?
Step 1 - stop (stop moving/find a distraction)
Step 2 - squeeze (Kegels x10sec, calf raisesx10, squeeze/mini squatx10, mental distraction)
Step 3 - relax (let bladder fill more or walk safely to bathroom)
Step 4 - go
What is the more common scenario regarding UI and falls?
Waking from sleep with urge to urinate rushing to the bathroom
What are some Nocturia management techniques?
- stop fluids 2-3 hours before sleep
- use urgency inhibition strategies overnight
- urinal at bedside or commode
- manage LE edema 2-3 hours before bed (let body process fluids before going to sleep)
What is the difference in symptoms of a UTI in younger/older adults?
Younger:
- dysuria, urgency/frequency, suprapubic pain, hematuria
Older:
- confusion, delirium, falls
