80 Questions
What is a significant risk factor for falls in older people?
Gait disorders
When evaluating an older person for a gait disorder, what should be included in the history?
Questions on neurological, orthopedic, and medical symptoms or prior history
What should be documented when inquiring about the nature of the problems with walking?
Maximum walking distance
Who may be able to provide a collateral history regarding falls or walking difficulties?
Caregivers
Which system is responsible for interpreting the information received and selecting the motor programs required for walking?
Basal ganglia
What is the average preferred walking speed in healthy adults up to the age of 59 years?
1.4 m/s
Which part of the brain has a central role in generating automatic walking, particularly in primates?
Midbrain locomotor center
What percentage of the gait cycle does the swing phase take up?
40%
What is the purpose of the Timed Up and Go (TUG) test in the context of a gait disorder?
To measure the time it takes for the patient to stand up, walk a short distance, turn around, walk back, and sit down
Which neurological signs were observed in Joan's case suggestive of Parkinson’s disease?
Resting tremor, bradykinesia, and rigidity
What is a common pharmacologic role in managing gait disorders in older individuals?
Deprescribing to reduce the risk of falls in older individuals with gait disorders
Which level of gait disorder is associated with movement disorders like Parkinson’s disease?
Middle level
What is a sensitive marker of general health and survival in older adults?
Walking speed
What is the most common non-neurological cause of gait disorders?
Hip and knee osteoarthritis
What correlates more closely with the future emergence of dementia in elderly non-demented persons?
Gait disorders
Which activity is a common indicator of overall health status in elderly persons?
Walking
What is the role of cognition in gait, as discussed in the text?
Cognition plays a role in circumnavigating obstacles and choosing the optimal route
How does anxiety influence gait, as per the text?
Anxiety results in an overly cautious gait
What is the purpose of the timed up and go (TUG) test, as described in the text?
To evaluate the risk of falling in geriatric patients
Why is it important to observe the entire patient while walking, as emphasized in the text?
To identify any orthopaedic abnormalities that may affect gait
What is the purpose of gait analysis in the evaluation of a patient?
To provide an overview of how the structures involved in walking are functioning
What distinguishes medium-level gait disorders from low-level gait disorders?
Medium-level gait disorders have focal neurological symptoms and signs, while low-level gait disorders are due to peripheral musculoskeletal problems.
In the context of gait and balance performance testing, what are the characteristics of high-level gait disorders (HLGD)?
High-level gait disorders present as slow gait with shorter strides and hypokinetic-rigid signs.
What should be included in the assessment for Parkinson's disease according to the text?
A thorough medical and social history focused on gait and falls, in addition to an ophthalmological examination
What should be documented when evaluating the clinical examination of gait?
Posture, gait initiation, and walking speed
What are the risk factors for falls in older people according to the text?
Limited physical activity, difficulties rising from a sitting position, and impaired postural reflexes
What is the most common cause of falls in elderly persons according to the text?
Pre-existing difficulties with walking and balance
What is included in the general measures to prevent falls and fall-related injuries according to the text?
Checking entire list of medication, muscle training, and removing risks at home
What is the most common neurological cause of gait disorders according to the Bruneck study?
Sensory ataxia
What is the change in preferred walking speed per year in apparently healthy elderly subjects?
0.5 m/s
What changes occur in the strategies for standing and walking when there is a threat to balance in healthy individuals?
Posture becomes stooped
In the Bruneck study, what percentage of elderly people living in the community had a gait disorder between the ages of 60 and 69 years?
10%
What is the most common reason for non-neurological gait disorders in adults?
Osteoarthritis
How is an antalgic gait characterized?
Avoidance of weight-bearing and fixed ankle position
What is the purpose of carrying walking aids, such as crutches, on the unaffected side in patients with gait disturbances?
To shift weight away from the affected side to the upper extremity
What is a typical cause of coxalgic gait?
Hip pain
How do patients with antalgic gait lift and lower their foot?
In a fixed ankle position
What do patients with antalgic gait appear to be walking as if?
Having a thorn in the sole of the foot
Why do patients with antalgic gait put weight on the affected leg for as short a time as possible?
To avoid pain
What is a characteristic feature of patients with coxalgic gait?
Use of crutches on the affected side
What is the primary purpose of inquiring about the nature of the problems with walking when evaluating an older person for a gait disorder?
To identify any underlying conditions and narrow the differential diagnosis
What is an important aspect of the history that must be included when evaluating an older person for a gait disorder?
Documentation of any neurological, orthopedic, and medical symptoms or prior history
What role does caregivers play in the evaluation of gait disorders in older people?
Providing a collateral history regarding falls or walking difficulties
What is a critical consideration when evaluating gait disorders in older people?
The maximum distance the patient can walk without resting
What should be included in the assessment of an older person for a gait disorder according to the text?
Documenting the maximum walking distance and number of rests needed
What is the purpose of a medication review in the evaluation of patients?
To identify the side effects of sedating or blood pressure lowering drugs
In gait analysis, what parameters should be clinically examined?
Step length, stride length, rhythm, and posture
What is a distinguishing feature of medium-level gait disorders?
Reduced arm-swing and clock-face turning
What is a characteristic of high-level gait disorders (HLGD) caused by cerebrovascular disease?
Shorter strides and poor balance leading to falls
What should be included in the assessment for Parkinson's disease according to the text?
A thorough medical and social history with a focus on gait and falls
What is the relationship between walking speed and individual life expectancy in elderly persons, as mentioned in the text?
Faster walking speed in elderly persons is associated with a longer life expectancy
What is the prevalence of gait and balance disorders in those over 80 years, according to the text?
More than 60%
What does a slow gait in elderly non-demented persons correlate more closely with, as mentioned in the text?
The future emergence of dementia
What is the most common cause of severe injuries in the elderly, as mentioned in the text?
Falls
What is the role of cognition in walking, as discussed in the text?
Intact cognition and executive control are required for safe walking
What is the role of cognitive control in walking, as discussed in the text?
Circumnavigating obstacles and choosing the optimal route
Which psychological factor is associated with slower gait, as indicated in the text?
Depression
What strategy do healthy individuals adopt when there is a risk of falling, as per the text?
Maintaining balance over other tasks
What test is used to evaluate the risk of falling in geriatric patients, as mentioned in the text?
Timed Up and Go (TUG) test
What type of gait pattern is lost in patients with Parkinson’s disease, according to the text?
Posture first strategy
What is the approximate percentage of the gait cycle that the swing phase takes up?
40%
What is the average preferred walking speed in healthy adults up to the age of 59 years?
1.4 m/s
What is the role of the midbrain locomotor center in the context of walking?
Generating automatic walking in primates
Which measure of gait refers to the linear distance covered by one gait cycle?
Stride length
What is an important measure of gait that represents the number of steps per unit of time?
Cadence
What is the purpose of carrying walking aids, such as crutches, on the unaffected side in patients with gait disturbances?
To alleviate pressure on the affected side and provide better support
How does anxiety influence gait, as per the text?
It causes alterations in posture, muscle tone, and movement patterns
What distinguishes medium-level gait disorders from low-level gait disorders?
The involvement of movement disorders like Parkinson's disease
What system is responsible for interpreting the information received and selecting the motor programs required for walking?
Nervous system
What is a sensitive marker of general health and survival in older adults?
Grip strength
What should be considered when evaluating an older person for a gait disorder, based on the text?
The patient's medication and detailed questioning about any falls
What is a typical cause of coxalgic gait according to the text?
Hip arthritis
What percentage of elderly persons fall every year according to the text?
Approximately 30 %
What is a sensitive marker of general health and survival in older adults according to the text?
Age-related changes in preferred walking speed
What does the examination of gait in older people include, as discussed in the text?
Tandem gait, standing and walking on heels, and hopping on one foot
What is the relationship between polypharmacy and falls in the elderly, as per the newer studies?
Polypharmacy poses a risk if it includes medications that increase the risk for falls.
Why do healthy individuals exhibit changes in their standing and walking strategies when faced with a threat to balance?
To adopt protective gait strategies and compensate for the threat to balance.
What is the primary cause of the decline in walking speed in apparently healthy elderly subjects?
A decrease in step length rather than a change in cadence.
What does the Bruneck study indicate about the prevalence of gait disorders among the elderly?
There is a considerable overlap of patients affected by neurological as well as by non-neurological gait disorders.
What is indicated by the decline in individual walking speed in elderly subjects?
A decrease in muscle power and more reliance on distal proprioception with age.
Explore the relationship between polypharmacy and falls in elderly individuals. Learn about the medications that increase the risk of falls, such as sedatives, antidepressants, and benzodiazepines. Discover relevant risk factors for falls and general measures recommended for prevention.
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