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Geriatric Physio
Geriatric Medicine
Question | Answer |
---|---|
those with more positive self perceptions of aging lived __ years longer than those with negative self perceptions of aging | 7.5 |
traditionally age __ has been designated as elderly b/c it is the age at which people in industrialized societies generally leave the work force | 65 |
by 2030 __ of the US population will be older than 65 | 1/5 |
the healthcare cost per capita for persons aged 65 or older in the US is __ times greater than the costs for those under 65 years | 5 |
what is successful (healthy) aging | no debilitating disease/disability, active healthy life until death from "old age", no unwanted features "tooth loss" |
the number of people in the US older than 80 years is expected to __ in the years 2000-2030 | double from 9.3 million to 19.5 million |
currently a 70 year old man can expect to live until age | 83 |
currently a 70 year old woman can expect to live until age __ | 85 |
despite the best genetic makeup and medical care, no one seems to live much beyond __ years | 125 |
challenges of geriatric care | normal aging vs pathology, diversity of population, multiple chronic diseases, polypharmacy, diagnosis vs functional status |
depression in the elderly is the great __ | masquerader |
never underestimate the morbid significance of __ | vision and hearing loss |
care not __ | cure: support comfort, function, independance |
look for __ in elderly patients, it is always present | undiagnosed disease |
don't __ for mild conditions | overtreat |
don't __ for serious conditions | undertreat |
common diseases of the elderly | CAD, stroke, cancer, osteoporosis, arthritis, diabetes, depression |
normal aging changes/disease progression (general) | increased fat, decreased total body water |
obesity in the elderly __ | is a disease not a normal part of aging |
consequence of increased fat and decreased body water in the elderly | drug effects-fat vs water soluble, increased risk for dehydration |
how is cost of elder care funded | 57% public programs, 25% patient's families, 18% private insurers |
3 categories of aging | senescence, normal aging, successful aging |
refers to the common complex of diseases/impairments that affect many older people, wide spectrum, as people age very differently | normal aging |
three factors influencing longevity | heredity, lifestyle, exposure to environment |
four predominant physiologic changes associated with normal aging | musculoskeletal, eyes, fat distribution, internal organ changes (cardiac output, renal function) |
general change in total body water | declines 46-60% |
change in muscle mass | 30% decrease |
change in taste buds | 70% decrease |
change in cardiac reserve | decreased CO |
change in max heart rate | 195-155 bpm |
change in lung vital capacity | 17% decrease |
change in renal perfusion | reduced by 50% |
change in cerebral blood flow | reduced by 20% |
change in bone mineral content | reduced by 25-30% in women 10-15% in men |
change in brain wt | reduced by 7% |
change in amount of light reaching the retina | diminished by 70% |
change in plasma glucocorticoid levels | no change |
3 body composition changes | decrease in lean body mass, increase in fat storage, decrease in total body water |
body composition changes can affect | drug metabolism |
5 musculoskeletal changes | loss of bone mass, degenerative joint changes, loss of muscle mass, foot problems, decrease in stature |
consequences of musculoskeletal changes | leads to fall risks/increasing daily pain |
10 common geriatric diseases at 65-74 | HTN, diabetes, glaucoma, cataract, CAD, osteoarthritis, dermatoses, arrhythmias, lipid disorders, bronchitis |
many older people tend to conceal __ and do not seek medical care until the problems become major | minor problems |
you must not only treat the disease but you must maintain __ | function |
assessment to identify and manage fixable problems | clinical assessment |
assessment to maximize independence through human, mechanical, or environmental manipulations | functional assessment |
Successful primary care for the frail/complex older adult is based on | a special knowledge set and on a philosophy of care |