Elderly Fall Risk

1. Which of these is not a basic activity of daily living

   1. Ambulation

   2. Feeding

   3. Dressing

   4. Transportation

   5. Toileting

Transportation

1. What are the two main musculoskeletal changes with aging that increase fall and fracture risk?

   1. Increased fat and stronger bones

   2. Sarcopenia and osteopenia

   3. Muscle growth and bone strengthening

   4. Increased joint lubrication and flexibility

   5. Muscles have regrown and shortened

Sarcopenia and osteopenia

1. What is the primary biomechanical factor contributing to increased fall risk in elderly adults?

   1. Decreased muscle cross-sectional area leading to reduced joint torque

   2. Increased tendon stiffness improving stability

   3. Greater stride length variability increasing momentum

   4. Increased sarcomere number enhancing joint mobility

   5. Higher skeletal density improving shock absorption

Decrease muscle cross-sectional area leading to reduced joint torque

1. Which of the following correctly describes the roles of osteoblasts and osteoclasts in bone tissue?

   1. Osteoblasts break down bone, while osteoclasts build new bone.

   2. Osteoblasts build new bone, while osteoclasts break down bone.

   3. Both osteoblasts and osteoclasts build bone, but in different locations.

   4. Both osteoblasts and osteoclasts break down bone, but in different locations.

   5. None of the above

Osteoblasts build new bone, while osteoclasts break down bone

1. Which of the following intrinsic factors most strongly contributes to elderly fall risk?

   1. Trip hazards in the home

   2. Poor footwear

   3. Solitary lifestyle and medication use

   4. Poor lighting conditions

   5. Slippery floors

Solitary lifestyle and medication use

1. Your grandfather had a bad fall a year ago, what would you recommend to him to prevent falls?

   1. Give him a chair lift so he doesn’t fall on the stairs

   2. Encourage regular movement and balance exercises

   3. Remove all the rugs in the house

   4. Get him a wheelchair so he doesn't have to walk around the house

   5. Grandpa can continue as he is

Encourage regular movement and balance exercises

1. Explain Wolff’s Law and how it relates to bone health in elderly individuals.

Wolff’s Law states that bone adapts to the stress placed upon it; bones become stronger when regularly loaded and weaker when not used. In elderly individuals, decreased activity or long periods of bed rest reduce mechanical loading, causing bone loss and increasing the risk of fractures from falls

1. Explain why morbidity is a driver of healthcare costs.

The years between the end of the health span and the end of the life span place the patient at risk for several injuries and illnesses. The patients often can’t move, are confined to a bed or a wheelchair. Due to this lack of movement, they develop osteopenia and sarcopenia which makes them susceptible to further falls and illnesses which will cause more money spent on their health.

1. Explain the relationship between muscle wasting and fall risk in the elderly.

Sarcopenia reduces muscle strength and coordination, decreasing balance and stability during movement, which increases the risk of falls.

Explain the difference between mortality and morbidity

Mortality refers to death and one’s lifespan, while morbidity refers to the ability to live independently, or one’s health span.

1. What does the process of how falling is related to morbidity look like?

Someone is living healthily and then they fall. This leads to a fear of falling and hence they become more sedentary. Then they get weaker and eventually fall again and this time they hurt something. Then they have a bigger fear of falling, become more sedentary, become weaker and fall again, they get hurt again but worse and this cycles until they are hospitalized. Biomedical engineers can design solutions such as smart balance monitors, home-based motion detection or new clinical balance exercises.

1. What is the difference between life span and health span

Life span is the time from birth to death. Health span is how long you are healthy and able to live on your own. Health span is characterized by the ability to complete activities of daily living, such as ambulation, feeding yourself, dressing, etc. and instrumental activities of daily living such as transportation, financing, shopping, etc. There is approximately a 12 year gap between the two.

1. How does patient education reduce the risk of falls in the elderly.

Patient education can reduce the fall risk in the elderly by reducing risk factors such as tripping hazards, slippery floors, solitary lifestyle and fear of falling. If patients are aware of the extrinsic fall factors they can remove them from the home or reduce the risk. The intrinsic fall factors can be reduced by encouraging patients to work out and improve their balance to prevent falls. Patients who have fallen should be encouraged to resume movement after a fall.