Instability and Immobility Flashcards
What is sarcopenia?
The loss of skeletal muscle mass and strength with old age
Give seven caused of sarcopenia
Diabetes/Insulin resistance Elderly Chronic Disease Lack of use Inflammation Nutritional Deficiency Endocrine dysfunction
Give five causes of vertigo
Labyrinthitis Acute ear infection Benign Paroxysmal Positional Vertigo (BPPV) Meniere's disease Cerebellar or Brainstem pathology
Describe the intrinsic factors which increase risk of falls
Gait/balance problems - postural instability - vertigo Syncope - vagal / cardiac Visual problems Chronic disease - neurological / msk Vitamin D deficiency Acute illness e.g. infection Cognitive disorder - delirium / dementia - depression/anxiety
Describe the extrinsic factors which increase risk of falls
Poor lighting Inappropriate footwear Environmental hazards - uneven paving - carpets - stairs - walking aids
Describe the situational factors which increase risk of falls
Urgency of micturition
Alcohol
Medications
Give six classes of drugs which can increase the risk of falls in the elderly
Antidepressants Antispychoics Anticholinergic / antimuscarinics Benzodiazepines Antihypertensives Diuretics
Give eight ways in which gait and balance can be assessed
Sitting to standing ability Static standing balance Romberg test Dynamic standing balance Gait analysis Tinetti gait and balance scale Berg balance scale (Timed) "get up and go" test
What investigations should be done for a patient who has had an episode of syncope?
History Collateral history Examination - BP, Cardio, Neuro 12 lead ECG Assess for red flags (Consider further tests)
What are the potential physical complications of immobility?
Muscle wasting Muscle contractures Pressure Sores Deep venous thrombosis Constipation / incontinence Hypothermia Hypostatic pneumonia Osteoporosis
What are the potential psychosocial complications of immobility?
Depression
Loss of confidence
Isolation
Institutionalisation
