History & Examination

Question 1

what’s the projected percentage of the population that will be over the age of 65 in 2030? What’s the fastest growing age group in the United States?

Answer 1

20%

age 85 and over.

Question 2

how will the population age over 65 change by race by 2050

Answer 2

non-hispanic whites will decrease by 22 percent
hispanics will increase from 7 to 20 percent.
blacks, asians, and others will increase

Question 3

what types of adults over 65 tend to live alone the most?

Answer 3

Females >males.
black and non hispanic whites of all female races
black men of all male races

Question 4

what percentage of older adults report good to excellent health? who tends to rate their health is better?

Answer 4

76% total

non hispanic whites rate their health as good more than other races

Question 5

If an older adult reports unintentionally lost 10 pounds or more over the last year and/or fatigue, what are you concerned about?

Answer 5

advanced progressive illness

depression, cancer, and chronic digestive system problems

Question 6

about how many people between the ages of 65 and 74 meet physical activity guidelines? >85 people?

Answer 6

14%

4%

Question 7

how many adults have one chronic condition? how many have at least 2?

Answer 7

80%

50%

Question 8

What are the top two chronic conditions affecting older adults?

Answer 8

hypertension (54%M, 57%F)
arthritis (45%M, 56%F)
heart disease

Question 9

What’s the most prevalent self-reported condition causing activity limitation in older adults?

Answer 9

arthritis/other musculoskeletal

heart/circulatory comes next

Question 10

Arthritis is more prevalent in what older adult population?

Answer 10

obese individuals

women>men

Question 11

older people with chronic dizziness or imbalance are how many times more likely to fall in comparison with older people who do not experience these problems?

Answer 11

2 to 3 times mroe

Question 12

What’s the most prevalent sensory impairments among persons over 70 years and over? what are three others, ranked most to least prevalent?

Answer 12

balance impairment 75.3%
loss of feeling in feet 27.2%
hearing impairment 26.3%
visual impairment 15.4%

Question 13

What percentage of individuals over age 65 reported a functional limitation? how many had difficulty with IADLs? how many lived in a facility?

Answer 13

41%
12%
4%

Question 14

percentage of medicare enrollee age 65 and over with functional limitations by setting— who has most percetage with 3 or more ADL limitations?

Answer 14

long term care facilities (68% of them)

Question 15

common physical activities that are difficult to perform for people over 65 (highest percent of people who can’t do it to lowest)

Answer 15

walking 2-3 blocks
stooping/kneeling
lifting 10 lbs
reaching over head
write/ grasp small objectst

Question 16

What is the OPTIMAL?

Answer 16

APTA’s Outpatient Physical Therapy Improvement in Movement Assessment Log
an insturment that measures difficulty and self-confidence in performing 22 movements that a pt/client needs to accomplish in order to do various functional activities
each item rated 1-5
1= no difficulty
5= unable to do

Question 17

What is the Katz ADL Index?

Answer 17

tool that assesses BASIC ADLs (bathing/dressing/toileting/transfering/continence/feeding).
no formal reliability and validity reports
used extensively as a flag for function
0= lowest = pt very dependent
6=highest= pt independent

Question 18

What is the Lawton IADL scale?

Answer 18

provides self-reported information about functional skills necessary to live in the community (using phone, shopping, food prep, housekeeping, laundry, mode of transportation, responsibility for own meds, ability to handle finances)
for each item 1= highest
0=dependent

Question 19

what’s the ABC scale?

Answer 19

subjective measure of confidence in performing various ambulatory activities without falling. Patients rate their balance confidence on 16 items on a rating scale that ranges from 0-100

Question 20

What is SPLAT?

Answer 20

mnemonic for fall history 
Symptoms (differentiate accidental fall from syncope)
Previous falls
Location of fall
Activity at time of fall
Time of fall

Question 21

What drug classes that are common in older adults?

Answer 21

-psychotropic meds:
sedatives-hyptonic
antianxiety
antidepressants
antipsychotics
-neurologic agents
-analgesics and anti-inflammatory drugs
-cardiovascular drugs

Question 22

Bone mineral density. normal, osteopenia, osteoperosis cut offs

Answer 22

greater than -1.0 normal
-1.0 to -2.5 osteopenia
<-2.5 osteoporosis

Question 23

What’s included in cardiovascular/pulmonary systems review?

Answer 23

heart rate, respiratory rate, blood pressure, and edema

Question 24

What’s included in Integumentary systems review?

Answer 24

pliability (texture), presence of scar formation, skin color, and skin integrity

Question 25

What’s included in the Musculoskeletal system review?

Answer 25

gross symmetry, gross range of motion, gross strength, height, and weight

Question 26

What’s included in the Neuromuscular system review?

Answer 26

general assesment of gross coordinated movement (ie balance, gait, locomotion, transfers, and transitions) and motor function (motor control and motor learning)

Question 27

What’s included in the Communication ability systems review?

Answer 27

affect, cognition, language, and learning style, the assessment of the ability to make needs known; consciousness; orientation (person, place, and time); expected emotional/behavioral responses; and learning preferences (ie learning barriers, educational needs)

Question 28

Blood Pressure:
Optimal?
Pre-HTN?
HTN Stage 1?
HTN Stage 2?
HTN Stage 3?

HR should increase by how much per MET level?
Orthostatic hypertension?

Answer 28

Optimal= 120/80
Pre-HTN= 120 to 139/80-89
HTN Stage 1= 140-159/90-99
HTN Stage 2= 160-179/100-109
HTN Stage 3= >or= 180/ >or=110

HR should increase 10-12bpm and SBP should increase 10-12 mmHG per MET level

Orthostatic HTN= drop in SBP by 20mmHG or DBP by 10mmHG

If pt has either resting or exercise HTN, refer for medical management.

Question 29

What is normal aging integument?

What should you look out for?

Answer 29

thinning dermis; wrinkles; decreased collagen and elastin; more prone to hermorrhages (senile purpura)

look out for:

• skin tears secondary to decrease in pain perception at site of purpura
• skin conditions such as xerosis (dryness), cellulitis, shingles, scabies
• skin cancer
• pressure ulcers (decubiti) [heels, sacral area, occiput]

Question 30

what are the 3 heights you need to include?

Answer 30

height in typical standing posture
height in conscious erect posture
max height during lifetime

Question 31

What should be included about bladder and bowels to systems review?

Answer 31

urinary frequency
urgency
incontinence
reduced force of stream
difficulty initiating
dysuria
color

bowel: changes in regularity.