Exam (elaborations)
Clin Skills Lecture 1 Comprehensive Geriatric Assessment
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Clin Skills Lecture 1 Comprehensive Geriatric Assessment
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1 of 55Term
How can you optimize the environment of a Comprehensive
Geriatric Assessment?
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1. Gait speed
- immobility
2. Muscle Strength
- swallowing disorders
3. Combination Testing (Timed up &
- malnutrition
go)
, •Cellulitis, pressure ulcers, urinary - Well lit
retention / UTIs with indwelling - minimal backlighting
catheters - minimal extraneous noise
•Nocturia →falls / sleep deprivation - minimize interruptions
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2 of 55
Term
What is functional status?
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Measure of overall impact of patient's health in context of environment and
social support network
•Reflects ability to perform tasks necessary for usual activities and roles
1) Name 3 objects, repeat them back, give them a task, circle back and ask them
to repeat 3 items
= 3 points can receive partial credit
2) Clock drawing
= 2 points all or nothing on the points
Points
Total of 5 possible point
*3 points or less is concerning!
•Responding in the affirmative to one or both of these questions is a positive
screening test for depression that requires further evaluation
, •Includes five lists of nearly 100 medications or medication classes to avoid or
use with caution for some or all older adults
•Aims to guide health professionals away
from potentially harmful medications
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3 of 55
Term
What is the leading cause of nursing home admission?
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Stress Incontinence Urge Incontinence
Urinary Incontinence Overflow Incontinence
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4 of 55
Term
What are examples of problems due to medications?
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, Traditional Definition
•Cut points range from 2-11
•Most common 5 or 9
•≥10: excessive polypharmacy
Alternative Definition
•Lack of indication
•Lack of efficacy
•Therapeutic duplication
•Falls
•Fractures
•Bleeding/hematoma
•Accidents: e.g. motor vehicles, pedestrians
•Polypharmacy, drug interactions & adverse events: Caused / exacerbated
by meds (e.g. hemorrhage - anticoagulants)
•Cellulitis, pressure ulcers, urinary retention / UTIs with indwelling catheters
•Nocturia →falls / sleep deprivation
1) Increased mortality
- Risk of 6-month mortality is twice that of patients without delirium
- Symptomatology duration increases risk
2) Increased risk for future cognitive impairment
- Impacts ability to live independently
- Predicts drop in MMSE scores
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