Prevention

Question 1

What is the major outcome of chronic diseases other than death?

Answer 1

Disability

Question 2

What are the MC CA’s?

Answer 2

1. Lung
2. Colorectal
3. Breast

Question 3

What percentage of older adults have HTN?

Answer 3

40%

Question 4

What percentage of adults have heart disease?

Answer 4

1/3

Question 5

What percentage of disabilities occur chronically and progressively as chronic diseases become more severe?

Answer 5

1/2

Question 6

What is the most feared outcome of disability?

Answer 6

Loss of independence

Question 7

List the precursors to disability

Answer 7

1. Difficulty walking
2. Cognitive impairment
3. Visual impairment

Question 8

Define Primary Prevention

Answer 8

Intervention to prevent dz or injury

Question 9

List examples of Primary Prevention

Answer 9

1. Vaccines
2. BP monitoring
3. Exercise
4. Seat Belts
5. Home Environment evaluation*
6. Oral Care*

Question 10

Define Secondary Prevention

Answer 10

Intervention for those with EARLY CONDITION to prevent PROGRESSION into complications

Ex: Smoking cessation in pt’s with arterial dz

Question 11

What is an examples of Secondary Prevention

Answer 11

Screenings:

1. Mammography <75
2. Colonoscopy, FOB
3. Vision

Question 12

Define Tertiary Prevention

Answer 12

Efforts to IMPROVE CARE to AVOID late complications

Ex: Chronic Dz management

Question 13

List examples of Tertiary Prevention

Answer 13

1. Proactive Primary Care
2. Comprehensive Geriatric Assessment
3. Foot Care
4. Toileting
5. Rehab

Question 14

What two factors is the benefit of prevention dependent on?

Answer 14

1. PREVALENCE of problem

2. LIKELIHOOD of an effective intervention

Question 15

What is prevention in older adults targeted at?

Answer 15

Prevention of Syndromes:

1. Falls
2. Dizziness
3. Functional decline
4. Incontinence

Question 16

What is the benefit of pneumonia prevention (vaccines)?

Answer 16

1. Decrease need for hospitalizations

2. Decrease functional decline

Question 17

What is the benefit of osteoporosis prevention?

Answer 17

Cost effective in elderly

Question 18

Define Multimorbidity

Answer 18

Decreased risk of one dz may leave older people more vulnerable to others

Ex: Decreasing SBP below 120/80 can cause dizziness/falls d/t decreased profusion to brain

Question 19

What is the USPTF recommendations for prevention screening

Answer 19

1. Regular “periodic” screening
2. 65+: Screening, counseling, immnunizations
3. Welcome to Medicare visit

Question 20

Screening for psychosocial problems

Answer 20

1. PHQ-9
2. Beck Depression Inventory
3. Geriatric Depression Scale

Question 21

Screening for cognitive impairment

Answer 21

Mini Mental Status Exam

Question 22

What is the recommended amount of physical activity in older adults?

Answer 22

150 minutes/week of moderate intensity

Question 23

What does low BMI or unintentional weight loss >10 lbs in 6 months indicate?

Answer 23

Poor nutrition and disease

Question 24

What can you use to help identify those @ risk for malnutrition?

Answer 24

Mini Nutritional Assessment (MNA)

Question 25

What is the most preventable problem in older adults?

Answer 25

Iatrogenesis

Question 26

List common Iatrogenic problems

Answer 26

1. Excessive Testing/Overevaluation*
2. Polypharmacy
3. Oversedation
4. Fluid overload
5. Abx overuse

Question 27

What is the leading iatrogenic event in LTC facilities?

Answer 27

Learned Dependence

Question 28

Management of falls

Answer 28

1. PT & OT
2. Gait training, muscle strength training, adaptive behaviors
3. Assistive devices
4. Environment manipulations
5. Hip protectors