Geriatrics Midterm

What age defines the 'geriatrics' population?

65 years and older.

What is the ratio of geriatricians to the population in the US?

8.6 geriatricians for every 100,000 people.

At what age does muscle mass loss typically begin?

Age 30.

What is the term for the gradual loss of muscle mass, strength, and function that affects people aged 60 and over?

Sarcopenia.

Sarcopenia is characterized by the loss of which specific type of muscle fibers?

Type II (fast-twitch) muscle fibers.

At what age does sarcopenia significantly accelerate?

Age 60.

What is the recommended frequency for weight/resistance training for older adults?

3 days per week.

What is the recommended intensity for resistance training in older adults, expressed as a percentage of 1-repetition maximum (1RM)?

50-70% of 1RM.

Resistance training stimulates the recruitment of _____ cells to support hypertrophy of mature myofibers.

satellite

In women, what is the typical rate of cortical bone mass loss per year post-menopause?

2-3% per year.

What are the three most common sites for osteoporotic fractures?

Hips, wrist, and spine.

What is the gold standard diagnostic tool for osteoporosis?

A DEXA scan.

What does a DEXA T-score of <2.5 indicate?

Osteoporosis.

What does a DEXA T-score between 1.0 and 2.4 indicate?

Osteopenia.

The principle that bone adapts to the load under which it is placed is known as _____ Law.

Wolff's

What is presbyopia?

The inability for the eyes to focus on near objects due to the stiffening of the lens.

Which age-related hearing change is most common in older adults?

Loss of hearing for high-pitched sounds.

What specific intolerance results from a reduced fat barrier under the skin in older adults?

Cold intolerance.

What general outcome results from a decrease in the number of cells in the spinal cord and slower nerve conduction after age 60?

Decreased sensation and reduced nervous system response.

What common cardiovascular condition is known as 'the silent killer' and affects half of people over 65?

Hypertension (HTN).

What common condition results from a decline in Vitamin D, Calcium, and Vitamin B12 absorption in older adults?

Malnutrition.

What type of bacteria is commonly present in the gut microbiota of healthy, long-living people?

Bacteroidetes.

What is referred to as an imbalance of microorganisms in the gut?

Dysbiosis.

Weakness of what muscle makes an older adult's cough less forceful, increasing infection risk?

The diaphragm.

In older women, weakness of which sphincter can lead to urinary leakage?

urinary

Which of the '5 I's' of pathological aging includes the '3 D's' (Depression, Dementia, Delirium)?

Intellectual Impairment.

What is the name of the screening tool used to assess for depression in the elderly?

Yesavage Geriatric Depression Scale (GDS).

On the Yesavage Geriatric Depression Scale (GDS), a score of 12 indicates what level of depression?

Severe depression.

What is the most common form of dementia?

Alzheimer's disease.

What two simple tests are often involved in the clinical assessment for dementia?

Item recall and the clock drawing test.

What aspect of a patient's life with dementia must be reviewed at every clinic visit?

Safety in their current living situation.

Which of the '3 D's' is characterized by an acute, sudden onset of confusion and is often reversible if the underlying cause is treated?

Delirium.

Delirium is often confused with which other cognitive condition?

Dementia or Alzheimer's.

What is the easiest type of delirium to recognize, characterized by anxiety, pacing, and hallucinations?

Hyperactive delirium.

What type of delirium is characterized by inactivity, sluggishness, and drowsiness?

hypoactive

What condition is characterized by diffuse musculoskeletal pain for over 3 months and tenderness at 11-18 specific points?

Fibromyalgia.

Polymyalgia Rheumatica is characterized by pain in the proximal joints of which two areas?

The shoulders and pelvic girdle.

In which geriatric condition is muscle strength unaffected?

Polymyalgia Rheumatica.

Temporal Arteritis, also known as Giant Cell Arteritis, commonly affects which artery?

The carotid artery.

What does the 'I' in the '5 I's' stand for when referring to adverse drug reactions (ADRs)?

Iatrogenic Drug Reactions.

On average, how many medications and supplements is an older adult taking?

An average of 12.

Which of the following is NOT one of the 5 I's of pathological aging: Intellectual impairment, Immobility, Irritability, Instability?

Irritability.

What are the top two leading causes of death in the US for older adults?

1. Cardiovascular Disease, 2. Cancer.

What mnemonic can help remember stroke symptoms?

5 D's, 3 N's, and A.

What are two of the 'D's' in the stroke symptoms mnemonic?

Any two of: Dysphasia, dysarthria, dysmetria, dizziness, nausea.

Which region of the US is identified as having the highest risk for health adversity?

The Southwest.

Compared to their white counterparts, African Americans are 30% more likely to die from what disease?

Heart disease.

Among adults with disabilities, what are the two most commonly reported types of disability?

Mobility and cognition.

What is an example of ageism regarding elderly individuals and technology?

Assuming an elderly person cannot use technology, or not providing resources for them to learn.

What is the recommended daily protein intake for older adults to counteract sarcopenia?

1.2-2.0 g/kg of body weight per day.

What is the key change in muscle that causes neuromuscular slowing with age?

Loss of fast-twitch, Type II muscle fibers.

What type of training is best for improving reaction time and balance to prevent falls?

Power training.

Around what year is the US population of people over 65 projected to exceed the population of children and adolescents?

2040

What is the term for the gradual loss of muscle mass, strength, and function that typically affects people ages 60 and older?

Sarcopenia

Sarcopenia primarily affects which type of muscle fibers responsible for strength and power movements?

Type II (fast-twitch) muscle fibers.

What are the recommended resistance training guidelines for managing sarcopenia in older adults?

Weight and resistance training 3 days/week, at 50-70% of 1-repetition maximum (1RM), for 7-9 reps and 2-3 sets.

What is the recommended amount of protein per meal for older adults managing sarcopenia?

20-30g of protein per meal.

Normal age-related muscle mass loss begins around what age?

30

By the 8th decade of life, what percentage of skeletal muscle mass is estimated to be lost due to normal aging?

30%.

What are the weekly physical activity guidelines for older adults to improve health according to the CDC?

Moderate aerobic exercise for 30 minutes/day 5 days/week AND muscle-strengthening exercise 2-3 days/week for all major muscle groups.

What is the typical rate of cortical bone mass loss in women per year post-menopause?

2-3% loss per year.

What is Wolff's Law?

Bone grows and remodels to adapt to the forces placed upon it.

Why are water aerobics and swimming considered less effective for improving bone health?

They do not place significant stress on the bones.

What is the term for the age-related inability of the eyes to focus on near objects?

Presbyopia.

What pathological eye conditions are NOT associated with normal aging?

Glaucoma, retinopathy, macular degeneration, and cataracts.

What type of hearing loss is considered a part of normal aging?

Sensorineural hearing loss.

Adherence to which diet showed the highest lower risk for hearing loss?

The DASH (Dietary Approaches to Stop Hypertension) diet.

In normal aging of the cardiovascular system, the walls of the arteries become what?

Thicker and less elastic.

What is the effect of calorie restriction on blood vessels?

It reduces oxidative stress, allowing nitric oxide (NO) to keep blood vessels open and healthy.

In the normal aging of the digestive system, the ability to absorb which three key nutrients declines?

Vitamin D, Calcium, and Vitamin B12.

What is the imbalance in microorganisms living in the microbiome that can lead to digestive problems in older adults?

Dysbiosis.

What are the Five I's of pathological aging in geriatrics?

Intellectual impairment, Incontinence, Immobility, Instability, and Iatrogenic Drug Reactions.

Which type of urinary incontinence is characterized by involuntary detrusor contractions?

Urge Incontinence.

Stress incontinence occurs when what puts pressure on the bladder?

Intra-abdominal pressure.

What rheumatological condition is characterized by pain primarily in the proximal joints?

Polymyalgia Rheumatica (PMR).

Temporal Arteritis most commonly affects which artery?

The carotid artery.

What is the leading cause of morbidity and mortality in the elderly?

Instability, which leads to falls and fractures.

What are the three components of Intellectual Impairment, also known as the '3 D's'?

Depression, Dementia, and Delirium.

How is Delirium differentiated from Dementia in terms of onset?

Delirium has a rapid onset, while Dementia has a slow, gradual onset.

What is the expected recovery for a patient with Delirium if the underlying cause is treated?

Mental status can return to the previous functional level.

What is the expected recovery for a patient with Dementia?

Progressive deterioration that cannot be reversed.

In the Geriatric Depression Scale (GDS) short form, what score range indicates mild depression?

A score of 7 +/- 3.

What is the most common cause of dementia?

Alzheimer's disease.

List three modifiable risk factors for dementia.

(Answer not provided in the source material.)

What are the two brain lobes that decrease in size in later stages of Alzheimer's Disease?

The temporal and parietal lobes.

What are the two hallmarks of Alzheimer's Disease detectable with neuroimaging?

Amyloid plaques and Tau tangles.

What is the term for the language disorder that can be a symptom of Alzheimer's disease?

Aphasia.

What does 'Type 3 Diabetes' describe in relation to Alzheimer's Disease?

Insulin resistance within the brain.

What score on the 4AT test suggests Delirium?

A score of 4 or more.

What type of delirium is characterized by restlessness and agitation?

Hyperactive Delirium.

What are the top 5 causes of mortality in older adults in the U.S.?

1. Cardiovascular Disease, 2. Cancer, 3. Stroke, 4. Chronic Lung Disease, 5. Alzheimer's Disease.

What clinical sign of a stroke spares the forehead?

Facial drooping.

What mnemonic is used to remember the neurological signs of a potential stroke?

The 5 D's (Dysphasia, Dysarthria, Dysmetria, Dizziness, Diplopia), 3 N's (Nausea, Nystagmus, Numbness), and an A (Ataxia).

What is the most common type of cancer in the US?

Skin cancer.

What is a major red flag for cancer that should be investigated immediately?

Significant weight loss without trying.

Osteoporosis most commonly affects which three areas of the body?

The hips, wrist, and spine.

What is the gold standard for baseline bone mineral density testing for osteoporosis?

A DEXA scan of the hip.

What is the leading cause of disability in older adults?

Osteoarthritis.

What single factor is a stronger determinant of health-related outcomes than race?

Socioeconomic status.

What is the definition of ageism?

Prejudicial attitudes and behaviors against older people based on their age.