Polypharmacy and Falls in the Elderly
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Questions and Answers

What is a significant risk factor for falls in older people?

  • Neurological system
  • Musculoskeletal system
  • Gait disorders (correct)
  • Sensory systems

    • When evaluating an older person for a gait disorder, what should be included in the history?

  • Questions on respiratory problems only
  • Questions on neurological, orthopedic, and medical symptoms or prior history (correct)
  • Questions on prior history of diabetes only
  • Questions on vision and hearing only

    • What should be documented when inquiring about the nature of the problems with walking?

  • Maximum walking distance (correct)
  • Maximum sitting distance
  • Maximum standing distance
  • Maximum running distance

    • Who may be able to provide a collateral history regarding falls or walking difficulties?

    <p>Caregivers</p> Signup and view all the answers

    Which system is responsible for interpreting the information received and selecting the motor programs required for walking?

    <p>Basal ganglia</p> Signup and view all the answers

    What is the average preferred walking speed in healthy adults up to the age of 59 years?

    <p>1.4 m/s</p> Signup and view all the answers

    Which part of the brain has a central role in generating automatic walking, particularly in primates?

    <p>Midbrain locomotor center</p> Signup and view all the answers

    What percentage of the gait cycle does the swing phase take up?

    <p>40%</p> Signup and view all the answers

    What is the purpose of the Timed Up and Go (TUG) test in the context of a gait disorder?

    <p>To measure the time it takes for the patient to stand up, walk a short distance, turn around, walk back, and sit down</p> Signup and view all the answers

    Which neurological signs were observed in Joan's case suggestive of Parkinson’s disease?

    <p>Resting tremor, bradykinesia, and rigidity</p> Signup and view all the answers

    What is a common pharmacologic role in managing gait disorders in older individuals?

    <p>Deprescribing to reduce the risk of falls in older individuals with gait disorders</p> Signup and view all the answers

    Which level of gait disorder is associated with movement disorders like Parkinson’s disease?

    <p>Middle level</p> Signup and view all the answers

    What is a sensitive marker of general health and survival in older adults?

    <p>Walking speed</p> Signup and view all the answers

    What is the most common non-neurological cause of gait disorders?

    <p>Hip and knee osteoarthritis</p> Signup and view all the answers

    What correlates more closely with the future emergence of dementia in elderly non-demented persons?

    <p>Gait disorders</p> Signup and view all the answers

    Which activity is a common indicator of overall health status in elderly persons?

    <p>Walking</p> Signup and view all the answers

    What is the role of cognition in gait, as discussed in the text?

    <p>Cognition plays a role in circumnavigating obstacles and choosing the optimal route</p> Signup and view all the answers

    How does anxiety influence gait, as per the text?

    <p>Anxiety results in an overly cautious gait</p> Signup and view all the answers

    What is the purpose of the timed up and go (TUG) test, as described in the text?

    <p>To evaluate the risk of falling in geriatric patients</p> Signup and view all the answers

    Why is it important to observe the entire patient while walking, as emphasized in the text?

    <p>To identify any orthopaedic abnormalities that may affect gait</p> Signup and view all the answers

    What is the purpose of gait analysis in the evaluation of a patient?

    <p>To provide an overview of how the structures involved in walking are functioning</p> Signup and view all the answers

    What distinguishes medium-level gait disorders from low-level gait disorders?

    <p>Medium-level gait disorders have focal neurological symptoms and signs, while low-level gait disorders are due to peripheral musculoskeletal problems.</p> Signup and view all the answers

    In the context of gait and balance performance testing, what are the characteristics of high-level gait disorders (HLGD)?

    <p>High-level gait disorders present as slow gait with shorter strides and hypokinetic-rigid signs.</p> Signup and view all the answers

    What should be included in the assessment for Parkinson's disease according to the text?

    <p>A thorough medical and social history focused on gait and falls, in addition to an ophthalmological examination</p> Signup and view all the answers

    What should be documented when evaluating the clinical examination of gait?

    <p>Posture, gait initiation, and walking speed</p> Signup and view all the answers

    What are the risk factors for falls in older people according to the text?

    <p>Limited physical activity, difficulties rising from a sitting position, and impaired postural reflexes</p> Signup and view all the answers

    What is the most common cause of falls in elderly persons according to the text?

    <p>Pre-existing difficulties with walking and balance</p> Signup and view all the answers

    What is included in the general measures to prevent falls and fall-related injuries according to the text?

    <p>Checking entire list of medication, muscle training, and removing risks at home</p> Signup and view all the answers

    What is the most common neurological cause of gait disorders according to the Bruneck study?

    <p>Sensory ataxia</p> Signup and view all the answers

    What is the change in preferred walking speed per year in apparently healthy elderly subjects?

    <p>0.5 m/s</p> Signup and view all the answers

    What changes occur in the strategies for standing and walking when there is a threat to balance in healthy individuals?

    <p>Posture becomes stooped</p> Signup and view all the answers

    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?

    <p>10%</p> Signup and view all the answers

    What is the most common reason for non-neurological gait disorders in adults?

    <p>Osteoarthritis</p> Signup and view all the answers

    How is an antalgic gait characterized?

    <p>Avoidance of weight-bearing and fixed ankle position</p> Signup and view all the answers

    What is the purpose of carrying walking aids, such as crutches, on the unaffected side in patients with gait disturbances?

    <p>To shift weight away from the affected side to the upper extremity</p> Signup and view all the answers

    What is a typical cause of coxalgic gait?

    <p>Hip pain</p> Signup and view all the answers

    How do patients with antalgic gait lift and lower their foot?

    <p>In a fixed ankle position</p> Signup and view all the answers

    What do patients with antalgic gait appear to be walking as if?

    <p>Having a thorn in the sole of the foot</p> Signup and view all the answers

    Why do patients with antalgic gait put weight on the affected leg for as short a time as possible?

    <p>To avoid pain</p> Signup and view all the answers

    What is a characteristic feature of patients with coxalgic gait?

    <p>Use of crutches on the affected side</p> Signup and view all the answers

    What is the primary purpose of inquiring about the nature of the problems with walking when evaluating an older person for a gait disorder?

    <p>To identify any underlying conditions and narrow the differential diagnosis</p> Signup and view all the answers

    What is an important aspect of the history that must be included when evaluating an older person for a gait disorder?

    <p>Documentation of any neurological, orthopedic, and medical symptoms or prior history</p> Signup and view all the answers

    What role does caregivers play in the evaluation of gait disorders in older people?

    <p>Providing a collateral history regarding falls or walking difficulties</p> Signup and view all the answers

    What is a critical consideration when evaluating gait disorders in older people?

    <p>The maximum distance the patient can walk without resting</p> Signup and view all the answers

    What should be included in the assessment of an older person for a gait disorder according to the text?

    <p>Documenting the maximum walking distance and number of rests needed</p> Signup and view all the answers

    What is the purpose of a medication review in the evaluation of patients?

    <p>To identify the side effects of sedating or blood pressure lowering drugs</p> Signup and view all the answers

    In gait analysis, what parameters should be clinically examined?

    <p>Step length, stride length, rhythm, and posture</p> Signup and view all the answers

    What is a distinguishing feature of medium-level gait disorders?

    <p>Reduced arm-swing and clock-face turning</p> Signup and view all the answers

    What is a characteristic of high-level gait disorders (HLGD) caused by cerebrovascular disease?

    <p>Shorter strides and poor balance leading to falls</p> Signup and view all the answers

    What should be included in the assessment for Parkinson's disease according to the text?

    <p>A thorough medical and social history with a focus on gait and falls</p> Signup and view all the answers

    What is the relationship between walking speed and individual life expectancy in elderly persons, as mentioned in the text?

    <p>Faster walking speed in elderly persons is associated with a longer life expectancy</p> Signup and view all the answers

    What is the prevalence of gait and balance disorders in those over 80 years, according to the text?

    <p>More than 60%</p> Signup and view all the answers

    What does a slow gait in elderly non-demented persons correlate more closely with, as mentioned in the text?

    <p>The future emergence of dementia</p> Signup and view all the answers

    What is the most common cause of severe injuries in the elderly, as mentioned in the text?

    <p>Falls</p> Signup and view all the answers

    What is the role of cognition in walking, as discussed in the text?

    <p>Intact cognition and executive control are required for safe walking</p> Signup and view all the answers

    What is the role of cognitive control in walking, as discussed in the text?

    <p>Circumnavigating obstacles and choosing the optimal route</p> Signup and view all the answers

    Which psychological factor is associated with slower gait, as indicated in the text?

    <p>Depression</p> Signup and view all the answers

    What strategy do healthy individuals adopt when there is a risk of falling, as per the text?

    <p>Maintaining balance over other tasks</p> Signup and view all the answers

    What test is used to evaluate the risk of falling in geriatric patients, as mentioned in the text?

    <p>Timed Up and Go (TUG) test</p> Signup and view all the answers

    What type of gait pattern is lost in patients with Parkinson’s disease, according to the text?

    <p>Posture first strategy</p> Signup and view all the answers

    What is the approximate percentage of the gait cycle that the swing phase takes up?

    <p>40%</p> Signup and view all the answers

    What is the average preferred walking speed in healthy adults up to the age of 59 years?

    <p>1.4 m/s</p> Signup and view all the answers

    What is the role of the midbrain locomotor center in the context of walking?

    <p>Generating automatic walking in primates</p> Signup and view all the answers

    Which measure of gait refers to the linear distance covered by one gait cycle?

    <p>Stride length</p> Signup and view all the answers

    What is an important measure of gait that represents the number of steps per unit of time?

    <p>Cadence</p> Signup and view all the answers

    What is the purpose of carrying walking aids, such as crutches, on the unaffected side in patients with gait disturbances?

    <p>To alleviate pressure on the affected side and provide better support</p> Signup and view all the answers

    How does anxiety influence gait, as per the text?

    <p>It causes alterations in posture, muscle tone, and movement patterns</p> Signup and view all the answers

    What distinguishes medium-level gait disorders from low-level gait disorders?

    <p>The involvement of movement disorders like Parkinson's disease</p> Signup and view all the answers

    What system is responsible for interpreting the information received and selecting the motor programs required for walking?

    <p>Nervous system</p> Signup and view all the answers

    What is a sensitive marker of general health and survival in older adults?

    <p>Grip strength</p> Signup and view all the answers

    What should be considered when evaluating an older person for a gait disorder, based on the text?

    <p>The patient's medication and detailed questioning about any falls</p> Signup and view all the answers

    What is a typical cause of coxalgic gait according to the text?

    <p>Hip arthritis</p> Signup and view all the answers

    What percentage of elderly persons fall every year according to the text?

    <p>Approximately 30 %</p> Signup and view all the answers

    What is a sensitive marker of general health and survival in older adults according to the text?

    <p>Age-related changes in preferred walking speed</p> Signup and view all the answers

    What does the examination of gait in older people include, as discussed in the text?

    <p>Tandem gait, standing and walking on heels, and hopping on one foot</p> Signup and view all the answers

    What is the relationship between polypharmacy and falls in the elderly, as per the newer studies?

    <p>Polypharmacy poses a risk if it includes medications that increase the risk for falls.</p> Signup and view all the answers

    Why do healthy individuals exhibit changes in their standing and walking strategies when faced with a threat to balance?

    <p>To adopt protective gait strategies and compensate for the threat to balance.</p> Signup and view all the answers

    What is the primary cause of the decline in walking speed in apparently healthy elderly subjects?

    <p>A decrease in step length rather than a change in cadence.</p> Signup and view all the answers

    What does the Bruneck study indicate about the prevalence of gait disorders among the elderly?

    <p>There is a considerable overlap of patients affected by neurological as well as by non-neurological gait disorders.</p> Signup and view all the answers

    What is indicated by the decline in individual walking speed in elderly subjects?

    <p>A decrease in muscle power and more reliance on distal proprioception with age.</p> Signup and view all the answers

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