Geriatric Health Assessment Quiz

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Questions and Answers

What is the most common risk factor for falls in the elderly?

Cardiovascular diseases

Muscle weakness (correct)

Poor nutrition

Dehydration

Which type of osteoporosis is primarily associated with estrogen withdrawal?

Age-related osteoporosis

Idiopathic osteoporosis

Secondary osteoporosis

Postmenopausal osteoporosis (correct)

What are the two major components of osteoporosis pathophysiology?

Bone formation and calcium supplementation

Bone formation and bone resorption (correct)

Bone resorption and hormonal regulation

Calcium intake and physical activity

How does chronic disease burden relate to the risk of falls in the elderly?

It increases frailty and reduces resilience Signup and view all the answers

In elderly patients, a high incidence of falls can lead to which serious consequence?

Hip and spine fractures Signup and view all the answers

What is the common age range for individuals who typically suffer from Traumatic Brain Injury (TBI)?

15-24 years old Signup and view all the answers

Which condition is known to experience increased prevalence by decade after the age of 60?

Parkinson's Disease (PD) Signup and view all the answers

What percentage of fractures occur in individuals over 50 years of age?

80% Signup and view all the answers

Which respiratory condition is particularly noted in adults over the age of 55?

Restrictive Lung Disease Signup and view all the answers

At what stage of life does the incidence of stroke notably increase?

After 55 years Signup and view all the answers

What characterizes primary osteoporosis?

It often follows menopause in women. Signup and view all the answers

Which of the following statements is true about osteoporosis?

It is the most common metabolic bone disease. Signup and view all the answers

What is a primary risk factor for postmenopausal women developing osteoporosis?

Low estrogen levels. Signup and view all the answers

What is the approximate annual turnover rate of cortical and trabecular bone in the adult skeleton?

10% Signup and view all the answers

What percentage of men is suggested to have osteoporosis?

20% Signup and view all the answers

Which cells are primarily responsible for the resorption of bone during the remodeling process?

Osteoclasts Signup and view all the answers

What does osteoporosis often lead to in older adults without symptoms?

Fractures and spinal deformities. Signup and view all the answers

What is the initial phase of the bone remodeling process called?

Activation Signup and view all the answers

Why is osteoporosis referred to as a 'silent thief'?

It goes undetected until significant damage occurs. Signup and view all the answers

What role do osteoblasts play in the bone remodeling process?

They form the bone matrix. Signup and view all the answers

What is the average age when bone mass peaks?

25-35 years Signup and view all the answers

How does the bone remodeling process contribute to metabolic functions?

It serves as a storehouse of essential minerals. Signup and view all the answers

What is the approximate overall yearly cost to the Canadian healthcare system for treating osteoporosis and related fractures as of 2020?

$4.6 billion Signup and view all the answers

What is left behind after osteoclasts resorb the bone during the remodeling process?

'Resorption cavity' Signup and view all the answers

Which of the following statements best describes the process of bone remodeling?

It is a continuous cycle of resorption and formation. Signup and view all the answers

What is the role of osteoclasts in bone health?

They break down old bone to allow for new bone growth. Signup and view all the answers

What is a common cause of non-union in fractures?

Too large a gap Signup and view all the answers

Which characteristic is NOT associated with frailty in older adults?

High exercise tolerance Signup and view all the answers

Which of the following is a component of the 'geriatric giants'?

Immobility Signup and view all the answers

What is polypharmacy typically defined as?

Five or more concurrent medications Signup and view all the answers

What happens to the risk of falling in the elderly when a new drug is initiated alongside previously prescribed medications?

It increases Signup and view all the answers

What is characterized by a loss or reduction in physiological reserve in older adults?

Frailty Signup and view all the answers

Which of the following factors is NOT considered extrinsic when assessing fall risk in the elderly?

Weak muscle strength Signup and view all the answers

What is a potential consequence of hip fractures in individuals with osteoporosis after a fracture?

High 6-month mortality rate Signup and view all the answers

What is the increased risk of a new vertebral fracture for women who already have one?

5-fold increase Signup and view all the answers

What percentage of women with a hip fracture are unable to walk independently?

40% Signup and view all the answers

Which type of fracture is likely to pose a risk for avascular necrosis of the femoral head?

Subcapital neck fracture Signup and view all the answers

Which factor does NOT influence the speed of bone healing?

Type of anesthesia used Signup and view all the answers

What is the main treatment approach for extracapsular fractures?

Reduction & internal fixation Signup and view all the answers

During which phase of bone repair does hematoma formation typically occur?

Within hours of fracture Signup and view all the answers

Which of the following is a potential complication of bone healing?

Delayed union Signup and view all the answers

What is the percentage of women who will suffer from another vertebral fracture within a year?

20% Signup and view all the answers

Which of the following factors is NOT considered when determining the speed of bone healing?

Patient's diet prior to injury Signup and view all the answers

Which type of fracture is most prone to complications such as nonunion or malunion?

Intracapsular fractures Signup and view all the answers

Study Notes

Osteoporosis (et al)

Osteoporosis is a chronic, progressive disease characterized by low bone mass and impaired bone quality.
Primary osteoporosis is most common and often follows menopause in women.
Secondary osteoporosis is associated with medications, other conditions or diseases.
The annual turnover of cortical and trabecular bone is about 10% of the adult skeleton and is important for maintaining structural integrity and calcium/phosphorous storage.

Metabolic Bone Changes

The human skeleton undergoes continuous remodeling throughout life.
Remodeling relies on two cells: osteoclasts which break down bone and osteoblasts which secrete the matrix for bone formation.
Bone remodeling progresses through three phases: activation, resorption, and formation.

Osteoporosis Overview

Osteoporosis is a metabolic bone disease that's expected to increase in prevalence with an aging population.
Estrogen deficiency is relevant because it promotes osteoblast activity.
Primarily, osteoporosis is more common in postmenopausal women.
Over 80% of fractures in people aged 50+ are due to osteoporosis.

Osteoporosis: Epidemiology

Osteoporosis-related fractures are more common than heart attacks, strokes, and breast cancer combined.
At least one in three women and one in five men will suffer an osteoporotic fracture in their lives.
Osteoporosis and fractures account for over 60% of inpatient rehabilitation admissions, costing over $2.3 billion CAD annually.

Osteoporosis: Etiology (Causes)

Bone mass peaks between 25 and 35 years old, and then bone resorption is greater than bone formation.
Significant risk factors are post-menopause; genetics; inactivity/immoblization; smoking and diet deficiencies in, calcium and Vitamin D.

Osteoporosis: Pathogenesis

Osteoporosis occurs due to an imbalance in the normal bone remodeling process, with bone resorption by osteoclasts favored over bone formation by osteoblasts.
This results in a loss of bone mass.
Age-related osteoporosis (type 2) arises from decreased Vit D and calcium absorption. –Post-menopausal osteoporosis (type 1) is driven by estrogen withdrawal.

Primary Osteoporosis Classification

Post-menopausal osteoporosis (type 1): Affecting post-menopausal women.
Age-related osteoporosis (type 2): Commonly impacting elderly men and women.

Post-Menopausal Osteoporosis (Type 1)

This type is strongly linked to estrogen withdrawal.
It most affects trabecular bone, causing a 5-20% yearly loss of spinal trabecular bone mineral.
Trabecular bone is also known as spongy bone, due to its open honeycomb-like structure.

Age-related decreases in dietary calcium and vitamin D absorption contribute to this kind of osteoporosis.
Kidney function reduces the body's ability to activate vitamin D.

Secondary Osteoporosis

This type of osteoporosis is less common than the primary type.
Secondary osteoporosis is characterized by conditions such as corticosteroid use, hyperparathyroidism, and immobilization negatively impacting bone formation.

Clinical Presentation

Initial symptoms may include a "Dowager's hump" (spinal kyphosis): increased curvature, stooped posture, loss of height, lower rib settling, and decreased spinal mobility.

Diagnosis of Osteoporosis

Diagnostic criteria are based on bone mineral density (BMD) measured by dual-energy x-ray absorptiometry (DEXA).
A DEXA scan involves the patient lying on a table while radio waves assess bone thickness.

Osteoporosis to Fractures

Fractures occur when applied forces exceed the bone's capacity.
Factors influencing bone capacity are mineralization level and the architecture of the bone.
Osteoporosis progressively deteriorates both mineralization and architecture increasing fracture risk.

Osteoporosis and Fracture Location

Osteoporosis often starts with "silent" fractures as the spine, hip, or wrist (Colle's fracture).
Pathological fractures from normal daily activities are highly indicative.
Spinal fractures denote a severe sequela of osteoporosis.
Hip fractures are common in older adults and represent the worst complication.

Vertebral Fractures

Women with vertebral fractures have a significantly increased risk of future fractures, with a 5-fold risk of another vertebral fracture and a 2-fold risk for a hip fracture.
One woman in five experiences another vertebral fracture within a year after a vertebral fracture.

Hip Fracture

Hip fractures carry substantial morbidity, with significant complications for the individual.
One year after a hip fracture, 30% experience permanent disability, 50% cannot walk independently, and up to 80% cannot independently perform daily tasks.

Usual Bone Repair

Bone repair progresses through several stages: hematoma formation, procallus formation, hard callus formation, callus replacement, and remodeling.

Speed of Bone Healing

Factors like the age and nutritional status of the patient, existing medical conditions, severity of bone damage, blood supply & nutrition at the site, effective treatment, and mobilization promote healing.

Bone Healing Complications

Delayed union: Inability for bone to properly unite due to insufficient blood supply, infection, or poor mobilization.
Malunion: Union where the bone heals with improper alignment.
Nonunion: When bone does not heal. Causes possibly due to insufficient blood supply or non-treatment of delayed union.
Avascular necrosis: Death of bone tissue occurs due to inadequate blood supply, impacting healing or causing other damage.

Hip Fracture & Frailty

After a hip fracture, there is a substantial mortality rate within 6 months, usually related to complications from immobilization.

What is meant by Frailty?

Frailty is a physiological decline and increased vulnerability in older adults.
Frailty is indicated by factors like weight loss, weariness, limited capacity for exercise, slow mobility, and possible cognitive impairment.

Geriatric Giants

Major causes of impaired functionality, like immobility, instability, incontinence, impaired memory, that frequently lead to frailty.

Chronic Disease, Age, & Frailty

Chronic diseases increase in prevalence with advancing age, regardless of gender.

Polypharmacy & Elderly

Polypharmacy represents the use of 5 or more medications by an elderly person, usually increasing frailty due to increased risks of falling, interactions, or other severe risks associated with multiple medications.

Osteoporotic Fractures, Frail Elderly & Fall Risk Factors

Extrinsic factors, chronic disease burden and medication, acute health care events, and muscle weakness, vision, and balance issues are associated with falls in osteoporotic patients.

Osteoporosis Summary

Osteoporosis is the most common bone disease caused by an imbalance of bone formation and absorption.
Two main forms exist: primary osteoporosis, predominantly post-menopausal and age-related; secondary osteoporosis associated with other conditions.
A major fall risk factor for the elderly.

Framing the RS 3060 Course

The first element of the course focuses on an anatomical-physiological view of common issues, covering anatomy to physiology.
The second element of the course focuses on clinical cases and the impact of the issues on patients' lives, covering etiology to pathophysiology and clinical presentation.

Health Conditions & Life Cycle Approach to Disabilities

Presents a wide array of health challenges across various stages of life.

Ignorance is Bliss

Clinical presentation should not be generalized with any client; the professional must take into account the nature of client need and differing factors.
Different needs mean different providers or settings such as acute care vs. chronic care vs. long term care.
Different needs and time expectations are critical to a patient's success, which vary by medical condition.

In going forward

These study notes end with wishes for success and good luck.

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Description

Test your knowledge on the common health risks and conditions associated with the elderly population. This quiz covers topics such as osteoporosis, falls, and traumatic brain injuries. It's essential for those studying geriatric health or working with aging patients.