Postural Control in Older Adults Flashcards
What are the 2 major factors to aging?
- genetic (primary)
- experimental (secondary)
_____ factors we have little control over, whereas _____ factors we have more control over
Genetic
experimental
What are a few examples of secondary aging factors?
- nutrition
- exercise
- insults
- pathologies
Describe the continuum of physical function among older adults from physically elite to disabled
1) physically elite
2) physically fit
3) physically independent
4) physically frail
5) physically dependent
6) disabled
Describe physically elite older adults
They engage in competitive sports and are considered to undergo optimal aging
Describe physically fit older adults
They engage in sports, hobbies, and games and are capable of moderate physical work
Describe physically independent older adults
They engage in less physically demanding activities such as gold or social dancing. They are also independent in all basic ADLS and instrumental ADLs
Describe physically frail older adults
They are usually independent in basic ADLs but are dependent in many instrumental ADLs. They are capable of light housekeeping, but often require assistance to continue living independently
Describe physically dependent older adults
They are dependent in both basic and instrumental ADLs and require full-time assistance.
How many individuals over the age of 65 fall each year?
1/3
Falls make up what percentage of unintentional injuries?
67%
Falls are the __ leading cause of death in the elderly
5th
About ___ of the deaths from falls occur in people over 65 years.
3/4
What are some intrinsic risk factors for fall in community-dwelling older adults?
- age and gender
- muscle weakness
- visual, gait or balance deficits
- history or fear of falls
- social isolation
- anxiety
- depression
- cognitive impairment
- impaired ADLs
What are some extrinsic risk factors for fall in community-dwelling older adults?
- stairs
- rugs
- slippery surfaces
- poor lighting
Falls result from the interaction of what 3 things?
The individual, the task and the environment.
What are 4 age-related changes in the musculoskeletal system of postural control?
- decreased muscle strength
- decreased ROM
- diminished spinal flexibility
- altered posture
Describe why there is a decrease in muscle strength with age
- the number of motor unit declines
- there is a loss of type I and II fibers
Is the reduction in muscle mass greater in UE or LE?
LEs
Are concentric or eccentric contractions more effected with age?
concentric
Is strength or endurance better preserved with age?
endurance
What does decreased ROM and loss of spinal flexibility in older adults lead to?
flexed or stooped posture
Due to this loss of spinal flexibility the center of mass moves in what direction?
Posteriorly, towards the ankles
What other joint loses flexibility as one ages?
ankle joint
Decreased extensor muscle strength results in what?
increased kyphosis
What postural changes occur in older adults?
- forward head
- increased kyphosis
- increased lordosis
- hip flexion
- knee flexion
How does the neuromuscular system contribute to postural control?
Through the coordination of forces effective in controlling the body’s position in space
True or False
Older adults have more difficulties controlling spontaneous sway during the quiet stance
True
When responding to a moving platform that causes postural sway, older adults demonstrate what 2 things?
- slower response onset (decreased response strategy) in key muscles
- increased co-activation to stiffen the joint
What are 2 compensatory mechanisms in aging?
- stepping reaction: forward or backward stepping with one or more lateral steps
- reaching reaction: initiation of arm movement and reach-to-grasp movement
In summary what are 3 motor system changes that can contribute to the inability to maintain balance as one ages?
1) muscle weakness
2) impaired timing and organization among synergistic muscles activated in response to instability
3) limitations in the ability to adapt movements for balance in response to changing task and environment demnads
What 3 sensory systems are affected by age?
- somatosensory
- visual
- vestibular
Does the threshold for vibratory sense (somatosensory system function) increase or decrease with age?
Increase
Does tactile sensitivity (somatosensory system function) increase or decrease with age?
decrease
Does the visual threshold increase or decrease with age?
increase
Does visual acuity increase or decrease with age?
decrease
Does aging cause a amplification or reduction in vestibular function?
reduction
By the age of 70 a person will have lost __% of their vestibular hair
40
Describe the difference of sensory adaptation between older and younger adults
Healthy older adults do not show a significantly larger sway than young adults when a single sense is reduced. However, when the availability of two senses is reduced, there appears to be a significant effect on steadiness.
Why might adults in their 70s and 80s have more difficulty maneuvering in the world?
Because they have lost some of their ability to integrate balance adjustments into ongoing voluntary movements such as lighting or carrying objects
Under what 3 circumstances does the majority of falls occur?
- walking
- lifting
- carrying
What happens to a person’s anticipatory adjustments as they age? What does this result in?
Older adults have problems making anticipatory adjustments quickly and efficiently, suggesting that impairments associated with anticipatory postural ability contribute to falls in many elderly people.
Can fear of falling significantly affect how we perceive and move in relation to balance control?
Yes
How do cognitive issues alter posture control?
When faced with situations in which they are required to perform multiple tasks at once they may not have the attention or information-processing capacity and therefore processing is reduced.
In order to test cognitive impairments that may affect balance one can perform what type of intervention?
Dual-Task Intervention
- Patient is asked to walk while performing subtraction by 3’s
The most important thing to remember is that aging is characterized by ______
heterogeneity
