Aging and Physical Therapy

This set of flashcards covers various key concepts related to aging, physical therapy, healthcare interventions, and fall prevention.

What is the reason age 65 is considered an arbitrary marker of ‘old age’?

It originated as a social construct for retirement benefits, not based on biology.

What best describes ageism in healthcare?

Discrimination or stereotyping based solely on age.

According to the APTA, ageism is described as ‘discrimination against _’

Our future selves.

What generational influence is reflected when a 75-year-old patient prefers face-to-face communication?

Traditionalist (Silent Generation).

Which component is NOT part of the Rowe & Kahn model of successful aging?

Maximizing lifespan regardless of function.

How does the Brown & Smith model expand the concept of successful aging?

By emphasizing quality of life and adaptation even with chronic conditions.

By 2030, what proportion of Americans is expected to be ≥65 years old?

1 in 5.

What currently ranks among the top causes of death for adults ≥65 years old in the U.S.?

Heart disease.

What does the Physical Stress Theory propose about aging?

Adaptation to stress is modifiable through lifestyle choices.

Which approach is best aligned with PT’s role in promoting successful aging?

Encourage lifelong exercise, engagement, and graded stress exposure.

What is the primary physical therapy goal in acute care for older adults?

Prevent deconditioning and initiate early mobility.

Approximately what percentage of older adults experience functional decline after hospitalization?

35%.

About what percentage of 30-day hospital readmissions among Medicare beneficiaries are considered preventable?

75%.

What setting requires a patient to tolerate 3 hours of therapy per day?

Inpatient Rehabilitation Facility (IRF).

To qualify for Medicare Part A Home Health PT, what status must a patient meet?

Homebound status due to the taxing effort required to leave home.

What is required for Medicare Part A coverage of Skilled Nursing Facility care after hospitalization?

At least a 3-night qualifying hospital stay.

Which patient is most appropriate for referral to Long-Term Acute Care (LTAC)?

A patient requiring >25 days of IV antibiotics and wound care.

What does ‘aging in place’ refer to?

Living independently at home with supportive services as needed.

What distinguishes Assisted Living from Independent Living facilities?

ALFs provide ADL assistance and meal services; independent living does not.

What best represents the PT’s responsibility within the continuum of care?

Advocate for safe transitions and coordinate care to maintain function.

At what age does an individual typically become eligible for full Medicare benefits?

65 years old.

Which service is covered under Medicare Part A?

Home health (limited).

Physical therapy services in an outpatient setting are reimbursed through which Medicare part?

Part B.

What accurately describes Medicare Advantage (Part C)?

It is a private plan that replaces Parts A and B and may include additional coverage.

Medicaid primarily covers which population?

Low-income individuals and families, including older adults.

What is the correct statement about VA healthcare?

Coverage applies only to service-connected conditions in VA facilities.

How long will Medicare Part A cover a patient’s stay in a Skilled Nursing Facility?

Up to 100 days.

In the Patient-Driven Payment Model (PDPM), PT reimbursement is primarily influenced by what?

Section GG functional scores and patient clinical categories.

What is the primary goal of the musculoskeletal exam for the aging adult?

Evaluate functional performance and independence.

Why are vital signs essential during the MSK evaluation of older adults?

They serve as a baseline for safety and exercise tolerance.

What trunk motion testing movement should be avoided in patients with osteoporosis?

Thoracic flexion and rotation.

An older adult performs a sit-to-stand without using upper extremity support. What strength grade does this roughly correspond to?

4+/5 to 5/5.

Which gait speed indicates increased risk for falls, hospitalization, and mortality?

What does a wall–occiput distance of 5 cm indicate?

Possible thoracic vertebral compression fractures.

Which joint position should be avoided when evaluating spinal ROM in lumbar spinal stenosis?

End-range extension.

Which performance-based test best assesses functional lower extremity strength and fall risk?

5x Sit-to-Stand Test.

What screening tool estimates a patient’s 10-year fracture risk based on factors?

FRAX Tool.

PTs should choose tests and measures for older adults that reflect what?

Both performance and participation.

What structural change occurs in the CNS with normal aging?

Decreased gray matter and myelin leading to reduced brain weight.

What is a common functional implication of central nervous system aging?

Decreased recall, slower processing, and delayed motor response.

Which neurotransmitters typically decline with age?

Dopamine, acetylcholine, and serotonin.

What contributes to poorer balance and coordination in older adults?

Cerebellar hemisphere shrinkage and vestibular receptor loss.

What primarily causes slowed nerve conduction velocity in the PNS of older adults?

Axonal degeneration and myelin loss.

What is the main reason for fiber regrouping in aging muscle?

Surviving motor neurons sprout new branches to reinnervate orphaned fibers.

Which sensory change most contributes to increased fall risk in older adults?

Decreased proprioception, vibration, and discriminative touch.

Which autonomic change is typical with aging?

Decreased vagal tone and increased sympathetic activity.

What functional issue results from slower peripheral conduction?

Delayed pain response and injury recognition.

What is the key recommendation regarding fall safety for older adults?

Pause after a fall to check for injuries before attempting to stand.

Which is a normal age-related change in the peripheral nervous system?

Decreased number and thickness of myelinated fibers.

What does a delayed H-reflex latency in an older adult most likely indicate?

Slower spinal reflex conduction.

Which visual condition is most associated with loss of central vision in older adults?

Age-related macular degeneration.

What explains a patient's difficulty with glare recovery and focusing on nearby text?

Presbyopia.

Which environmental modification best assists a patient with visual field loss from glaucoma?

Encouraging visual scanning and night lights.

Age-related hearing loss (presbycusis) typically affects which frequency range first?

High frequencies.

What strategy is most effective for communication with someone with hearing loss?

Facing the patient and lowering vocal pitch slightly.

What statement about smell and taste changes in aging is most accurate?

Reduced smell may lead to undetected gas leaks or spoiled food.

Why are older adults at a higher risk for dehydration?

Reduced thirst perception and fear of incontinence limit intake.

Which sensory change has the greatest effect on postural stability in older adults?

Proprioceptive inaccuracy.

With normal pulmonary aging, what is a hallmark change?

Increased lung compliance and airflow resistance.

What reflects normal age-related change in ventilatory response to hypoxia?

A decreased ventilatory response to hypoxia.

Why does a 60-year-old require more energy to breathe than a 20-year-old?

Chest wall rigidity and reduced lung elasticity.

What characterizes cardiovascular aging?

Reduced ability to maintain hemodynamic stability.

What factor contributes to decreased VO₂ max with aging?

Decreased stroke volume and capillary-to-fiber ratio.

What is a common presentation of pneumonia in older adults?

Confusion, fatigue, or functional decline.

What is the most prevalent cardiovascular disease in adults aged 65–75?

Hypertension.

What is a major cause of orthostatic hypotension in older adults?

Decreased autonomic regulation and blood volume.

What is one of the leading causes of death in older adults?

Functional decline.

Which statement regarding fall risk and medications is TRUE?

Taking two or more fall-risk-inducing drugs significantly increases fall risk.

How often should older adults be screened for fall risk?

Annually, or after any fall.

What is required for a full fall risk assessment according to STEADI?

‘Yes’ to any of the 3 key questions.

What score on the Stay Independent questionnaire signals elevated fall risk?

4.

Which component must be part of a comprehensive fall risk assessment?

Vision, sensation, vestibular, and strength testing.

If a patient has difficulty navigating curbs due to reduced depth perception, which sensory system is affected?

Visual.

What should the PT do if a patient is on multiple FRIDs?

Communicate concerns to the physician or pharmacist.

What combination best predicts future falls according to Landers et al. (2016)?

ABC, FFABQ, and TUG.

Where should the emphasis be placed during PT management of fall risk?

Early identification and personalized assessment to reduce future falls.

What should the primary goal of the musculoskeletal exam focus on?

Functional status and participation level.

What element is unique to the geriatric exam compared to younger adults?

Assessment of cognition, mood, and social supports.

What percentage of adults ≥65 years experiences at least one fall each year?

25%.

What is the most significant clinical consequence of gait decline in older adults?

Loss of independence and increased fall risk.

Which physiological change contributes to slower gait in older adults?

Reduced proprioception and ankle ROM.

How can a clinician differentiate between adaptive and pathological gait changes?

Evaluate both physical impairments and underlying diseases.

Which psychological factor reduces community ambulation in older adults?

Fear of falling.

Which pattern is typical of normal aging gait?

Decreased gait speed and stride length with increased double support time.

Which joint limitation causes inefficient swing initiation?

Hip extension loss.

What decline contributes most to delayed postural responses?

Vestibular and somatosensory systems.

Which neuromuscular change affects gait initiation?

Slower motor unit recruitment and reduced rate of force production.

What testing is best to evaluate lower extremity strength during gait assessment?

5x Sit-to-Stand test.

What score in gait speed correlates with safe community mobility?

1.0 m/s.

What must PTs prioritize during an exam for the elderly with thoracic kyphosis and chronic pain?

Posture assessment and fracture risk screening.

What contributes to functional decline post-infection in older adults?

Temporary regression in mobility and endurance.

How should PTs view falls in older adults?

As a chronic, preventable condition requiring continuous management.

Which intervention best reflects effective motor learning in older adults?

Allowing controlled loss of balance during practice with supervision.

What frequency of balance exercise is typically recommended?

Daily or near-daily.

What is an effective strategy for addressing fear of falling in therapy?

Educate that fear is normal but can improve with exposure and success.

What is the minimum recommended frequency for aerobic activity in older adults?

30 minutes, 5 days per week.

Which is a key recommendation for strength training in older adults?

3 sets of 10 reps at 60–80% 1RM.

What is the minimum overload threshold needed to stimulate muscle strength adaptation?

60% of 1RM.

What is the most appropriate recommendation regarding osteoarthritis in senior athletes?

Continue controlled strengthening and flexibility to maintain function.

What is the reason age 65 is considered an arbitrary marker of ‘old age’?

It originated as a social construct for retirement benefits, not based on biology.