geriatrics (1 + 2) Flashcards
1
Q
what percent of people over 65 are in nursing homes
A
4%
2
Q
____ is associated with earlier death (7.5 years), poorer physical and mental health, and poor health behaviors
A
ageism
3
Q
what is ageism
A
stereotyping, prejudice and discrimination based on age
4
Q
in 2020, people 65 and over comprised of ___% of the population in the US
A
20%
5
Q
for every 100 women between the ages of 65-74, there are ___ men
A
86
6
Q
___% of people over 85 live in long term care facilities
A
15%
7
Q
primary aging
A
inevitable
affects all systems
8
Q
secondary aging
A
caused by lifestyle, environment, and disease
9
Q
____% to ____% muscle loss per decade after 50
A
12-15%
10
Q
neuromuscular red flags in aging
A
confusion, seizures, sudden incontinence, gait abnormalities, loss of conciousness
11
Q
what is the #1 cause of death in the US in older populations
A
heart disease
12
Q
VO2 max declines __% per decade after 20
A
10%
13
Q
cataracts
A
clouding of lens due to protein buildup
14
Q
cataracts occur in ___% of 75 year olds
A
70%
15
Q
glaucoma
A
loss of peripheral vision
16
Q
macular degeneration
A
loss of clarity at center of visual field
17
Q
retinopathy
A
damaged blood vessels in eyes
18
Q
integumentary system makes up __% of our body weight
A
15%
19
Q
what is the largest organ in the body
A
skin
20
Q
a pressure sore can develop within how many hours
A
2 hours
21
Q
how is long term memory and procedural memory affected by age
A
it isn’t! these are relatively stable
22
Q
mild cognitive impairment (MCI) affects ___% of people age 65-74, and __% of people age 85+
A
19%
38%
23
Q
mild cognitive impairment increases risk for
A
alzheimer’s
24
Q
what is the most common form of dementia
A
alzheimer’s
25
delirium vs dementia
delirium is SUDDEN change of mental function whereas dementia happens over time
26
what are some symptoms of delirium
UTI
dehydration
hospitalization
drug interactions
27
what is the most common mental health condition in people over 65
depression
28
__% to __% of the older population has depression
11-16%
29
PHQ-2
2 question screening tool to identify depression
30
what are the 2 questions on the PHQ-2
1. have you ever felt down, depressed, or hopeless
2. have you felt little interest or pleasure in doing things?
31
a score of 3 or higher on the PHQ-2 indicates...
likelihood of major depressive disorder
32
cancer incidence has increased by __% in older adults in the last 30 years
26%
33
__x more likelihood of developing cancer as an older adult than younger
11x
34
African-Americans, American Indians, and Pacific Islanders are more susceptible to...
type 2 diabetes
35
what are the 4 degrees of frailty
1. fit
2. mild frailty (prefrail)
3. moderate frailty
4. severe frailty (end stage)
36
what are the 3 main risks of developing a stroke
1. age
2. high blood pressure
3. diabetes
37
__% of women 65+ have had a UTI within 12 months
10%
38
4 things to look for in potential stroke patients
face
arms
speech
time
39
what type of infection can mimic dementia symptoms
UTIs
40
how many times more likely are primary older adults to have pneumonia
4x
41
how many times more likely are primary older adults to be hospitalized from pneumonia
5x
42
what is the second leading cause of hospital acquired infection
pneumonia
43
pneumonia occurs in __% to __% of all hospital admissions
8-10%
44
pneumonia leads to__% of all diagnosis of sepsis
50%
45
what % of people die from pneumonia
33%
46
bone density score of osteoporosis
< -2.5 s.d. below 0
47
bone density score of osteopenia
<-1 s.d. below 0
48
what age is peak bone density
30
49
t/f: MCI interferes with ADLs
false
it reduces the person's capabilities compared to others in their age group/education level, but ADLs remain
50
4 atypical changes due to aging
mood changes
visuospatial changes
memory changes
communication difficulties
50
what type of condition has an inverse relationship with education
mild cognitive impairment (MCI)
51
PHQ-2
screening tool to identify depression in patients
52
what score on the PHQ-2 indicates a likelihood of major depressive disorder
3 or higher (out of 6 points total)
53
what is the highest cause of geriatric mortality
heart disease
54
polypharmacy
excesive or inappropriate use of medications
55
adults over 65 purchase over __% of all prescription medications
30%
56
___% of older people take at least 1 unnecessary drug
50%
57
average older adult takes ___ medications.
average nursing home resident takes ___ medications
5 meds
7 meds
58
how does aging affect absorption of drugs
decreased gastric acid
decreased stomach emptying
decreased gastric motility
59
how does aging affect distribution of drugs
decreased body water
increased body fat
decreased plasma proteins
decreased lean body mass
60
how does aging affect metabolism of drugs
decreased liver mass
decreased blood flow to liver
decreased enzyme activity
61
how does aging affect excretion of drugs
decreased kidney mass
decreased blood flow to kidneys
decreased nephron function
62
what 4 medications are most commonly overprescribed
laxatives
Blood pressure meds
Diuretics
Diabetes meds
63
what drugs could cause CONFUSION symptoms in older adults
antidepressants
analgesics
lithium
64
what drugs could cause DEPRESSIVE symptoms in older adults
barbiturates
antihypertensives
65
what drugs could cause FATIGUE/WEAKNESS symptoms in older adults
diuretics
glucocorticoids
66
what drugs could cause GI symptoms in older adults
NSAIDS
67
what is the key way of preventing polypharmacy
patient education
68
___% of people over the age of 65 reported at least ___ fall(s) in a year
29%
1 fall/year
69
medical treatment for falls cost more than ______ each year
$50 billion
70
what is the leading cause of death or hospitalization form injury in older adults
falls
71
3 medications that increase risk of falls
benzodiazepine
diuretics
sedatives
72
what is the cut-off speed for community ambulation
0.8m/s
73
what is the walking speed for independent ADLs
1-1.5 m/s
74
household walker speed
0-0.4 m/s
75
what sensory systems are involved with balance training
somatosensory
vestibular
visual
76
2 endurance tests to measure fall risk
6 min walk test
2 min step test
77
5 balance tests to measure fall risk
berg balance scale
sharpened romberg
4 square step test
functional reach test
miniBEST
78
4 functional tests to measure fall risk
5x sit to stands
30s sit to stands
TUG test
10m walk test
79
cut off time for fall risk TUG test? what about for community dwelling adults?
13.5s
8.5s for community dwelling adults
80
cut off time for fall risk on 5x sit to stand
11.4s
81
cut off score for fall risk on BERG
45/56
82
5 types of disabilities
ambulation
cognitive
visual
hearing
medical
83
define disability
mental or physical impairment that limits major activities in life in one or more ways
84
what % of people over 65 have a disability
34%
85
what is the most prevalent disability amongst the geriatric population?
What % of people 65 and older have this disability?
ambulatory
21%
86
ADL's vs IADL's
basic day to day activities (bathing, dressing, eating, etc)
vs
help you stay living INDEPENDENTLY FUNCTIONAL (shopping, cooking, cleaning, etc)
87
medicare
for 65+ or people disabilities
(AID the poor vs CARE for the elderly)
88
medicaid
low income
pregnant/responsible for minor
people with disabilities
(AID the poor vs CARE for the elderly)
89
required ambulation distance for discharging an older patient for INDEPENDENT living
400m
90
required gait speed for discharging an older patient for INDEPENDENT living
1.2 m/s
91
what is the required weight of being able to carry an object (like a gallon of milk) for discharging an older patient for INDEPENDENT living
8 lbs
92
what 3 terrains are patients required to walk on comfortably for discharging an older patient for INDEPENDENT living
carpet
grass
uneven surfaces
93
patient in an IPR facility will have ___ hours of therapy per day
3 hours
94
what is an SNF
skilled nursing facility
95
what is the functional capacity of an individual discharged to home health
limited ambulation for community but is safe to be at home and is functional
96
what does a typical patient present as in LTAC
high complexity of medical needs
poorer prognosis
less need for skilled therapy
97
what does palliative care address
psychological
social
spiritual
98
what does hospice care address
end of life care for terminal illnesses
aims to manage pain and symptoms
99
what is the life expectancy for people in hospice care
6 months or less
100
what type of illnesses do patients have in palliative care
chronic and serious illness
(not quite terminal illness or it would be hospice care)
101
what facility would a patient be put in if they are unable to participate in 3 hours of PT a day and are moderately functional
skilled nursing facility
102
advanced care directives
allows individuals to identify their preferences for care when they are unable to do so themselves
103
MOLST/POLST
Medical/Physician orders for life sustaining treatment
104
power of attorney
appoints an individual to make decisions on one's behalf
105
adults lose as much as __% of their strength between ages 60-90
40%
106
what is a good exercise option for aerobic and strength training for patients who cannot tolerate weight bearing well
aquatic exercise
107
Aerobic FITT recommendations for geriatric populations
F: 5-7 days/week
I: moderate tp vigorous
T: 20-30 min/day for 150+ min/week
T: prolonged, rhythmic activity
108
strengthening FITT recommendations for geriatric populations
F: 2-3 days/week
I: moderate to vigorous (60-80% 1RM)
T: n/a
T: 2-4 sets of 8-12 reps (major muscle groups)
109
flexibility FITT recommendations for geriatric populations
Frequency: 2-3+ days/week
Intensity: to feeling of tightness or slight discomfort
Time: hold 60 seconds 2-4 reps
Type: major muscle groups
110
frequency + time geriatric population should work on balance exercises
3+ days/week
2hr/week
111
5 neurological diseases that increase with age
stroke
dementia
epilepsy
ALS
parkinson's
112
t/f: difficulty learning new things is part of typical aging
true!
however, long term memory stays STABLE
