Geriatrics Final Mega set

What are the Geriatric 5 M's?

Mind, Mobility, Medications, Multi-complexity, Matters Most

What does the Mind component of the 5 M's address?

Cognition, dementia, delirium, depression, memory, and mental health

What does the Mobility component of the 5 M's address?

Falls, gait, balance, strength, and functional movement

What does the Medications component of the 5 M's address?

Polypharmacy, medication review, adverse drug events, and prescribing safety

What does Multi-complexity refer to?

Multiple chronic conditions and social determinants of health

What does Matters Most refer to?

Patient goals, values, preferences, and quality of life

What is dementia?

A progressive decline in memory and cognitive function that interferes with daily living

What is the most common cause of dementia?

Alzheimer disease

What screening tools are commonly used for dementia?

Mini-Cog, MMSE, MoCA, AD8, and Memory Impairment Screen

What are the three components of the Mini-Cog?

Three-word recall, clock drawing, and delayed recall

What is the score range of the MMSE?

0 to 30

What MMSE score is considered normal?

25-30

What MMSE score suggests moderate dementia?

10-20

What MMSE score suggests severe impairment?

Less than 10

What is delirium?

An acute change in cognition and attention caused by an underlying medical condition

How does delirium differ from dementia?

Delirium is acute and often reversible while dementia is gradual and progressive

What are common causes of delirium?

Infection, dehydration, medications, and metabolic disturbances

What characterizes hyperactive delirium?

Agitation, hallucinations, anxiety, and restlessness

What characterizes hypoactive delirium?

Lethargy, decreased responsiveness, and drowsiness

What characterizes mixed delirium?

Alternating hyperactive and hypoactive symptoms

What screening tool is commonly used for geriatric depression?

Geriatric Depression Scale (GDS)

What does PHQ stand for?

Patient Health Questionnaire

What symptom is most associated with depression?

Loss of interest in activities

What is late-onset essential tremor associated with?

Increased risk of dementia and cognitive decline

What is sarcopenia?

Age-related loss of skeletal muscle mass and strength

What is STEADI?

Stopping Elderly Accidents, Deaths, and Injuries

Who developed STEADI?

CDC

What score on the Stay Independent questionnaire indicates increased fall risk?

4 or greater

What three questions are especially important in the Stay Independent questionnaire?

Previous falls, feeling unsteady, and fear of falling

What is the Timed Up and Go test?

A mobility test measuring the time needed to stand, walk, turn, return, and sit

What TUG score indicates increased fall risk?

Greater than 12 seconds

What TUG score suggests independent mobility?

Less than 20 seconds

What TUG score suggests difficulty leaving the home?

Greater than 30 seconds

What does the 4-Stage Balance Test assess?

Static balance and fall risk

What finding on the tandem stance suggests increased fall risk?

Unable to hold for 10 seconds

What does SPLATT stand for?

Symptoms, Previous falls, Location, Activity, Time, Trauma

What is the purpose of SPLATT?

To determine the circumstances surrounding a fall

What does the Barthel Index measure?

Activities of Daily Living

What Barthel score indicates greater independence?

A score closer to 100

What exercise has the strongest evidence for fall prevention?

Tai Chi

Why is Tai Chi recommended for older adults?

Improves balance, coordination, strength, and fall prevention

According to the CDC, how many older adults fall each year?

Approximately 1 in 4 adults over age 65

What is the leading cause of injury-related death in older adults?

Falls

What is the most common cause of traumatic brain injury in older adults?

Falls

What is a FOOSH injury?

Fall On Outstretched Hand

What fractures commonly result from FOOSH injuries?

Radius, wrist, and radial head fractures

What are common fall-related fractures in older adults?

Hip, wrist, ankle, and arm fractures

What medication makes falls especially dangerous due to bleeding risk?

Blood thinners

What is orthostatic hypotension?

A drop in blood pressure when moving to a standing position

What symptoms are associated with orthostatic hypotension?

Dizziness, lightheadedness, syncope, and falls

What is the Berg Balance Scale?

A clinical balance assessment consisting of 14 tasks

What is the maximum Berg Balance score?

56

What does a higher Berg score indicate?

Better balance and lower fall risk

How are Berg Balance tasks scored?

0 to 4 points per task

Name three balance exercises for older adults.

Single-leg stance, tandem gait, and weight shifts

What is tandem gait?

Heel-to-toe walking in a straight line

What is the tree pose used for?

Balance training

What muscle groups are strengthened by squats?

Quadriceps, hamstrings, calves, glutes, core, and lower back

Why are squats important for older adults?

They improve function needed for sitting, standing, and toileting

What is polypharmacy?

The use of multiple medications simultaneously

What risks are associated with polypharmacy?

Falls, adverse drug events, cognitive impairment, hospitalization, and death

What is a prescribing cascade?

Treating a medication side effect with another medication

What three drug classes account for many adverse drug events in older adults?

Anticoagulants, antidiabetics, and opioids

What is a common anticoagulant example?

Warfarin

What is a common antidiabetic associated with ADEs?

Insulin

What are common opioid side effects in older adults?

Sedation, constipation, falls, and cognitive impairment

Which antihistamine is commonly listed as inappropriate for older adults?

Diphenhydramine (Benadryl)

Why should benzodiazepines be avoided in older adults?

Increased risk of falls, confusion, and cognitive impairment

Why should muscle relaxants be avoided in older adults?

Increased sedation and fall risk

What is multimorbidity?

The presence of two or more chronic diseases

What are examples of social determinants of health?

Education, income, housing, transportation, and healthcare access

What is patient-centered care?

Care based on patient goals, values, and preferences

What question best reflects Matters Most?

What matters most to you?

When should end-of-life discussions occur?

Before a healthcare crisis develops

What are the three phases of the Kirkaldy-Willis model?

Dysfunction, instability, and stabilization

Which phase is characterized by early degeneration?

Dysfunction

Which phase is characterized by excessive movement and pain?

Instability

Which phase is characterized by osteophyte formation and reduced motion?

Stabilization

What exercise recommendation was associated with stroke prevention?

Walking more than 12.5 miles per week

What diet pattern helps reduce stroke risk?

High fish, fruits, vegetables, whole grains, and low red meat

What does PART stand for?

Pain, Asymmetry, Range of motion, Tissue changes

What is manipulation?

A high-velocity low-amplitude thrust procedure

What is mobilization?

A low-force movement intended to improve motion

What is a chiropractic adjustment?

A treatment intended to improve neuromusculoskeletal structure and function

What is a subluxation?

An abnormal state of the neuromusculoskeletal system addressed by chiropractic care

What is the Neck-Shoulder-Scapula complex?

A common region of dysfunction in older adults involving posture and movement

What posture change is common in older adults?

Anterior head carriage

What symptoms are associated with anterior head carriage?

Neck pain, headaches, shoulder pain, and arm symptoms

What is characteristic of geriatric gait?

Stiff pelvis and decreased torso participation

Why should HVLA be avoided at the thoracolumbar junction in many elderly patients?

Increased risk from degeneration and fragility

What hip treatment is often useful in older adults?

Hip mobilization and traction

When should hip distraction not be performed?

Hip replacement or suspected femur fracture

What is a major safety concern before adjusting older adults?

Osteoporosis

Why is previous corticosteroid use important?

It increases fracture risk

What does pre-adjustive tension help determine?

Amount of resistance and appropriate force

What spinal curve often increases with age?

Thoracic kyphosis

What imaging may be needed for painful hyperkyphosis without trauma?

X-ray and DEXA scan

Why are stretching exercises important in older adults?

Improve elasticity, ROM, posture, and ADLs

What is an absolute contraindication to manipulation involving blood vessels?

Vertebrobasilar insufficiency

What vascular condition is a contraindication to manipulation?

Aneurysm