Neurologic and Gait Changes Flashcards
Week 3
What are common cognitive changes with aging?
Slowed processing speed, decreased cognitive flexibility, decreased sustained/divided attention, and decreased working memory.
Which type of memory remains intact with aging?
Semantic memory (crystallized intelligence), including vocabulary and recall of facts.
What brain structures are most affected by aging?
Frontal lobe (executive functions), basal ganglia (motor control, learning, behaviors), and cerebellum (coordination, postural control).
How does myelin change with aging?
Myelin degeneration, decreased myelin repair, and shortening of myelinated nerve fibers contribute to reduced nerve conduction speed.
How does aging affect motor units?
Fewer motor units with increased size, leading to reduced coordination and impaired timing of muscle activation.
What changes occur in the autonomic nervous system with aging?
Altered balance between sympathetic and parasympathetic systems, affecting gastric motility, bladder control, blood pressure regulation, and peripheral blood flow.
What are normal visual changes with aging?
Decreased visual field, acuity, contrast sensitivity, depth perception, and dark adaptation.
What is presbycusis?
Age-related sensorineural hearing loss characterized by decreased sound sensitivity, speech discrimination, and difficulty localizing sound.
How does peripheral neuropathy affect aging?
Reduced sensory and motor nerve conduction, loss of Achilles reflex, impaired proprioception, and increased fall risk.
What happens to taste and smell with aging?
Loss of taste buds (especially sweet/salty), blunted thirst mechanism, and reduced olfactory sensitivity.
How does vestibular function change with aging?
Decreased number of vestibular hair cells, nerve fibers, and degradation of otoconia, contributing to balance deficits.
What is postural control?
The ability to maintain stability by managing the body’s center of mass within the base of support.
What is the difference between anticipatory and compensatory postural adjustments?
Anticipatory: Pre-planned responses based on experience. Compensatory: Reflexive responses to unexpected perturbations.
What postural control strategies do older adults rely on more?
Hip strategy over ankle strategy due to decreased lower extremity strength and flexibility.
What environmental factors increase fall risk?
Poor lighting, slippery floors, clutter, improper footwear, and obstacles like area rugs.
What psychological factors contribute to falls?
Fear of falling, anxiety, depression, and reduced confidence in mobility.
What are intrinsic fall risk factors?
Muscle weakness, sensory impairments, vestibular deficits, postural hypotension, cognitive impairment, polypharmacy.
What are extrinsic fall risk factors?
Poor lighting, uneven terrain, lack of handrails, clutter, and unsafe footwear.
How does fear of falling impact function?
Leads to reduced mobility, increased sedentary behavior, muscle weakness, and higher fall risk.
What is the impact of sarcopenia on fall risk?
Reduced strength, balance, and coordination, leading to slower gait speed and impaired postural control.
What screening tools are used to assess fall risk?
Timed Up and Go (TUG), Berg Balance Scale, Functional Gait Assessment (FGA).
What are common gait changes associated with aging?
Decreased stride length, velocity, pelvic rotation; increased stance time, cadence, and base of support.
What is considered a normal gait speed in healthy older adults?
0.75-1.24 m/s.
What is the significance of gait speed in older adults?
Predictor of functional mobility, fall risk, hospitalization, and mortality.
What gait speed is needed for safe community ambulation?
At least 1.0 m/s; <0.8 m/s indicates limited community mobility and fall risk.
What are major neuromuscular contributors to gait decline?
Loss of motor units, reduced proprioception, impaired vestibular function, and decreased flexibility.
What outcome measures assess gait and balance in older adults?
TUG, 6 Minute Walk Test, Functional Gait Assessment, Dynamic Gait Index.
What is considered a ‘slow walker’ based on gait speed?
<0.6 m/s, indicating increased fall risk, hospitalization, and disability.
What is the importance of gait variability in fall prevention?
Increased gait variability, especially with mediolateral perturbations, is associated with higher fall risk.
What interventions can improve gait and reduce fall risk?
LE strengthening, balance training, proprioceptive training, postural education, and dual-task training.
How does cognitive load impact gait?
Divided attention (e.g., walking while talking) increases fall risk due to reduced executive function and motor planning.
What is the concept of ‘life space’ in older adults?
The geographic area an individual moves through daily, with a shrinking life space indicating reduced mobility and independence.
What is the average gait speed required to cross a street safely?
1.2-1.4 m/s.
What is physiological reserve, and why is it important?
The body’s ability to withstand stressors; reduced reserve leads to greater vulnerability to functional decline and falls.
How does energy reserve affect walking ability?
Older adults have reduced VO2 max, requiring more effort for daily activities, leading to fatigue and reduced mobility.
What is the best predictor of functional decline in older adults?
Decreased gait speed over 12 months is strongly associated with increased fall risk and mortality.
