Geriatrics

Question 1

What proportion of falls are estimated to result in hospital admissions?

Answer 1

Only 5% of falls result in hospitalisation. Despite this they make up ~14% of ED presentations.

Note: 65% of falls deaths were for people aged >85

Question 2

Define a fall

Answer 2

A fall is an event which results in a person coming to rest inadvertently on the ground, floor or other lower level

Question 3

How do we define orthostatic hypotension

Answer 3

Drop in SBP by 20mmHg or more

Or/

Drop in DBP by 10mmHg or more

Most common causes included dehydration and medications (multiple). Others include neurodenerative disorders, cardiac dysfunction, autonomic dysfunction, idiopathic.

The use of antidepressant drugs is often a major overlooked cause.

Question 4

Describe the process of a timed up and go test. What are normal values.

Answer 4

Instruct patient to get up from chair without using their arms, walk a fixed distance of 3m, turn around and return to seated position.

Normal <10sec
Elderly <12sec

Question 5

How is polypharmacy defined

Answer 5

Polypharmacy is historically defined as 5 or more medicines.

Hyperpolypharmacy is defined as >10 medicines