Term
| most common cause of traumatic brain injuries |
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Definition
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Term
| >95% of hip fractures caused by |
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Definition
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Term
| number of americans 65+ who fall every year and amount that tell their provider |
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Definition
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Term
| how many adults who fall can get up on their own |
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Definition
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Term
| leading cause of injury for older adults |
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Definition
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Term
| risk facxtors for falling |
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Definition
– Past history of fall
– Lower-extremity weakness – Age
– Female gender
– Cognitive impairment
– Balance problems
– Psychotropic drug use – Arthritis
– History of stroke
– Orthostatic hypotension – Dizziness
– Anemia |
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Term
| increased injury risk w falls |
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Definition
– Falls associated with syncope
– History of a fall with injury
– Decreased executive functioning (trail making test—Part B) |
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Term
| postural control and falls, sensory |
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Definition
• Age-relatedchangesimpactingposturalcontrol àincreasing fall risk
– Sensory:
• Proprioceptive sensory loss
• Impaired vestibular system
• Compounded by age-related CNS decline: loss of neurons and neurotransmitter (i.e., dopamine) depletion within the basal ganglia |
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Term
| postural control and falls, motor |
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Definition
– Muscle activation and composition:
• In response to changes in support surface, activate proximal (quadriceps) rather than distal (tibialis anterior) muscles
• Delayed muscle activation
• Recent studies have correlated fatty infiltration of muscle and risk for hip fracture |
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Term
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Definition
• Orthostatic hypotension
• Parkinson disease
• Chronic musculoskeletal pain
• Osteoarthritis in the knees
• Diabetes
• Cerebrovascular disease
• Cardiovascular disease
• Cognitive impairment
• Associated medication use |
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Term
| extrinsic vs intrinsic risk factors for falls |
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Definition
| intrinsic: gait/balance impairment, muscle weakness ect. extrinsic- environmental hazards, poor footwear, restrainst. then need precipitating cause (trip, syncope ect) |
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Term
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Definition
• Targeted history and physical
– History of prior falls, LE weakness
• Specific assessment of musculoskeletal function – “Get up and go”
– Functional reach test
– Sport Physical Performance Battery (SPPB)
– Divided attention tasks?
Physical exam:
– Postural vital signs to r/o postural hypotension
– Assess visual acuity
– CNXIII testing: Whisper test or hand-held audiometer
– Foot abnormalities: bunions, callouses, arthritic changes – Neurologic exam
Diagnostic testing: No standard panel |
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Term
| get up and go test for gait assessment |
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Definition
Have the patient sit in a straight-backed, high-seat chair
Instruction for patient:
Get up (without use of armrests, if possible)
Stand still momentarily
Walk forward 10 feet (3 meters)
Turn around and walk back to chair
Turn and be seated
Factors to note:
Sitting balance
Transfers from sitting to standing
Pace and stability of walking
Ability to turn without staggering
scoring 1-5 no fall risk to very high fall risk (physical support necessary)
(1) No fall risk
Well-coordinated movement, without walking aid
(2) Low fall risk
Controlled, but adjusted movements
(3) Some fall risk
Uncoordinated movements
(4) High fall risk
Supervision necessary
(5) Very high fall risk
Physical support of stand-by physical support necessary |
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Term
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Definition
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Term
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Definition
1. Minimize medications
2. Provide individually tailored exercise programs
3. Treat vision impairment (including cataracts)
4. Manage postural hypotension
5. Manage heart rate and rhythm abnormalities
6. Supplement vitamin D
7. Manage foot and footwear problems 8. Modify the home environment
9. Provide education and information |
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Term
| fall prevention modifiable risk factors |
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Definition
• Modifiable risk factors:
– Lower body weakness
– Vitamin D deficiency
– Medication use (including OTC) – Vision changes
– Poor footwear
– Treatment of some underlying medical conditions
Most falls are caused by a combination of risk factors More risk factors->increased fall risk |
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Term
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Definition
After a fall, many older adults become afraid of falling again
->Cut back on daily activities ->Become weaker
->Increase chance of falling |
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Term
| specific efforts for fall prevention |
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Definition
• Encouragechangespriortothefirstfall
• Reviewmedications,UTDDEXAscan
• Removeclutterfromhomes,openupwalkways • Removerugs
• Slowlyrisetostandinginthemorning
• Getonepairofgoodshoes
• Visiontestannually
• Legstrengthening—swimming,taichi
• Installrailings,grabbars,improvedlighting |
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Term
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Definition
| national council on aging |
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