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 (A)</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 (B)</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 (C)</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 (A)</p> Signup and view all the answers

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

<p>40% (B)</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 (A)</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 (B)</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 (D)</p> Signup and view all the answers

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

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

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

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

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

<p>Hip and knee osteoarthritis (D)</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 (B)</p> Signup and view all the answers

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

<p>Walking (C)</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 (B)</p> Signup and view all the answers

How does anxiety influence gait, as per the text?

<p>Anxiety results in an overly cautious gait (A)</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 (C)</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 (A)</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 (B)</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. (C)</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. (B)</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 (A)</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 (A)</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 (C)</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 (A)</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 (C)</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 (A)</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 (D)</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 (D)</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% (C)</p> Signup and view all the answers

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

<p>Osteoarthritis (B)</p> Signup and view all the answers

How is an antalgic gait characterized?

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

What is a typical cause of coxalgic gait?

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

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

<p>In a fixed ankle position (D)</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 (B)</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 (A)</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 (B)</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 (B)</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 (C)</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 (A)</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 (B)</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 (C)</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 (A)</p> Signup and view all the answers

In gait analysis, what parameters should be clinically examined?

<p>Step length, stride length, rhythm, and posture (C)</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 (A)</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 (A)</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 (D)</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 (B)</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% (B)</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 (B)</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 (C)</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 (D)</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 (A)</p> Signup and view all the answers

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

<p>Depression (A)</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 (C)</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 (D)</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 (C)</p> Signup and view all the answers

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

<p>40% (C)</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 (A)</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 (D)</p> Signup and view all the answers

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

<p>Stride length (C)</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 (B)</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 (C)</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 (B)</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 (A)</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 (B)</p> Signup and view all the answers

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

<p>Grip strength (B)</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 (C)</p> Signup and view all the answers

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

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

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

<p>Approximately 30 % (A)</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 (B)</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 (A)</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. (D)</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. (D)</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. (D)</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. (B)</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. (A)</p> Signup and view all the answers

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