Older Adults

What is dementia

Group of conditions that affects memory, language, problem solving, thinking or behaviour.

What is required for a diagnosis of dementia

Cognitive symptoms must significantly interfere with everyday function

List the 5 main types of dementia

Alzheimers
Vascular
Frontotemporal
Parkinsons disease dementia
Lewy body dementia

What is agnosia

Impaired ability to recognise or identify familiar objects, people or sounds

What is apraxia

Impaired ability to perform learned purposeful movements

What is aphasia

Impaired ability to understand or use language

What is fear of falling syndrome

Due to the fear, a person restricts activities, leading to reduced strength, balance and mobility

Describe the Timed Up and Go test

It measures the time to stand from a chair, walk 3 meters, return and sit down.

What should be observed during the TUG test

Stability, gait, balance, turning, sway and stepping problems

What TUG time suggests increased risk of mobility problems

20 secs or more.

List 5 symptoms that may indicate adverse effects from polypharmacy

Fatigue
Poor appetite
Dizziness
Confusion
Depression

Why can polypharmacy increase the risk of falls

Some medications cause dizziness, sedation, weakness, confusion, postural hypotension

How often should medication be reviewed in an older adult

Monthly review

Which digestive secretions may decrease with age

Gastric acid, intrinsic factor, pepsin

Which nutrients may be poorly absorbed in older adults

B12, iron, calcium

List 5 factors that contribute to malnutrition in older adults

Reduced appetite
Illness
Medications
Decreased taste and smell
Difficulty chewing or swallowing

List the early symptoms of dementia

Agnosia, apraxia, aphasia

List 3 symptoms of intermediate dementia

Personality and behavior changes occur.  
Often get lost.  
Unable to learn and recall new information.

List symptoms of late dementia

Pts cannot walk, feed themselves or other ADL.
Recent and remote memory is lost.
Eventually become mute.

What risk factors develop in late stage dementia

Risk of pneumonia, malnutrition, and pressure ulcers.
Eventually results in coma and death, usually due to infection.

What are prion mechanisms involved in

Alzeimers, parkinsons and frontotemporal dementia

Describe the process of a prion mechanism

A normal cellular protien becomes misfolded into a pathogenic form. This then acts as a template for other protiens.

What intervention may help an abnormal TUG result associated with reduced mobility?

Lower extremity strengthening

What should you investigate if a patient experiences dizziness during the TUG test?

Check orthostatic vital signs.
Review medications that may contribute to orthostatic hypotension.

What can path deviation during the TUG test indicate?

Peripheral neuropathy
Cerebrovascular disease

What interventions and diagnoses should be considered for patients demonstrating path deviation?

Possible peripheral neuropathy or neurological pathology.
Referral for a walking aid or assistive device.

What TUG findings may suggest normal pressure hydrocephalus (NPH)?

Increased postural sway and magentic gait.

What additional symptoms should you ask about if you suspect normal pressure hydrocephalus?

Urinary changes
Memory impairement
Gait disturbance

What is normal pressure hydrocephalus?

Excessive accumulation of cerebrospinal fluid (CSF) in the brain's ventricles.